By Deena Beasley
(Reuters) - The prices of drugs used to treat COVID-19 for those at risk of serious illness are "reasonably aligned" with how much they help patients, according to a draft report from drug-pricing research organization the Institute for Clinical and Economic Review (ICER).
The report assessed Pfizer Inc (NYSE:PFE)'s Paxlovid and Merck & Co's molnupiravir - both recently authorized antiviral pills - as well as sotrovimab, an intravenous monoclonal antibody drug developed by GlaxoSmithKline Plc and Vir Biotechnology Inc.
The three treatments - approved on an emergency basis for people with mild-to-moderate COVID-19 deemed at risk of progressing to serious illness - have been purchased by the U.S. government and are being distributed free-of-charge to healthcare providers.
The U.S. government has paid around $530 for a 5-day course of Paxlovid, $700 per five-day course of molnupiravir, and $2,100 for a course of sotrovimab - the lone available antibody treatment shown to work against the now dominant Omicron variant of the virus.
In clinical trials, ICER said molnupiravir cut hospitalization rates for high-risk patients by 30%, compared with 88% risk reduction for Paxlovid and 79% for sotrovimab.
"Right now the alignment of the price and benefits look reasonable," ICER President Steve Pearson (LON:PSON) told Reuters.
The Pfizer and Merck drugs are meant to be taken at home, while GSK's antibody is administered in hospital or infusion centers.
ICER also analyzed the cost-effectiveness of fluvoxamine, a 40-year-old generic pill used to treat conditions such as obsessive-compulsive disorder and depression at a cost of about $10 for a 10-day course.
Researchers from the University of Minnesota applied in December for emergency authorization of fluvoxamine for high-risk COVID patients after studies showed that the anti-depressant, which also has anti-inflammatory properties, reduced hospitalization rates by 32%.
ICER uses a decades-old formula called the quality-adjusted life year (QALY) – the cost of one year of good health for one patient – to estimate fair value.
By that and other measures, ICER said fluvoxamine offers the best value at $6,000 per QALY gained. It calculated Paxlovid was second at $18,000 per QALY gained, followed by molnupiravir at $55,000 and sotrovimab at $69,000.
Pearson said the pandemic has lots of "moving parts" and if the risk of hospitalization from infection with Omicron or a future variant proves to be lower, ICER's analysis would change.
The analysis applies only to use of the drugs for patients at elevated risk of severe COVID-19. If the treatments were used in lower-risk populations, "their cost effectiveness would be significantly reduced," ICER said.
ICER plans to accept public comment on its draft and issue an updated evidence report in late March.