{"doi":"10.1007/s40801-024-00427-0","title":"Economic Evaluation of Nirmatrelvir/Ritonavir Among Adults Against Hospitalization During the Omicron Dominated Period in Malaysia: A Real-World Evidence Perspective","abstract":"BACKGROUND AND OBJECTIVES: Nirmatrelvir/ritonavir was administered orally to manage mild to moderate symptoms of COVID-19 in adult patients. The objectives of this study were to (i) evaluate the cost-effectiveness of prescribing nirmatrelvir/ritonavir within 5 days of a COVID-19 illness in order to avert hospitalization within a 30-day period in the Malaysia setting; (ii) determine how variations in pricing and hospitalization rates will affect the cost-effectiveness of nirmatrelvir/ritonavir. METHODS: The 30-day hospitalization related to COVID-19 was determined using 1 to 1 propensity score-matched real-world data in Malaysia from 14 July 2022 to 14 November 2022. To determine the total per-person costs related to COVID-19, we added the cost of drug (nirmatrelvir/ritonavir or control), clinic visits and inpatient care. Incremental cost-effectiveness ratio (ICER) per hospitalization averted was calculated. RESULTS: Our cohort included 31,487 patients. The rate of hospitalization within 30 days was found to be 0.35% for the group treated with nirmatrelvir/ritonavir, and 0.52% for the control group. The nirmatrelvir/ritonavir group cost an additional MYR 1,625.72 (USD 358.88) per patient. This treatment also resulted in a reduction of 0.17% risk for hospitalization, which corresponded to an ICER of MYR 946,801.26 (USD 209,006.90) per hospitalization averted. CONCLUSION: In Malaysia, where vaccination rates were high, nirmatrelvir/ritonavir has been shown to be beneficial in the outpatient treatment of adults with COVID-19 who have risk factors; however, it was only marginally cost effective against hospitalization for healthy adults during the Omicron period.","journal":"Drugs - Real World Outcomes","year":2024,"id":440314,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9588,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":932962,"name":"Hoon Shien Teh","orcid":"0000-0002-4117-5494","position":1,"is_corresponding":false},{"id":932965,"name":"Nicholas Yee Liang Hing","orcid":"0000-0003-4530-8466","position":2,"is_corresponding":false},{"id":266012,"name":"Suresh Kumar Chidambaram","orcid":"0000-0001-9853-0373","position":3,"is_corresponding":false},{"id":266014,"name":"Mohan Dass Pathmanathan","orcid":"0000-0001-8385-0315","position":4,"is_corresponding":false},{"id":1251907,"name":"Wee Ric Kim","orcid":"0000-0003-1912-2940","position":5,"is_corresponding":false},{"id":1251908,"name":"Wei Jia Lee","orcid":"0009-0008-4062-5829","position":6,"is_corresponding":false},{"id":1252303,"name":"Zhi Wei Teh","orcid":null,"position":7,"is_corresponding":false},{"id":1252304,"name":"Maheshwara Rao Appannan","orcid":null,"position":8,"is_corresponding":false},{"id":1252305,"name":"Shahanizan Mohd Zin","orcid":null,"position":9,"is_corresponding":false},{"id":1252306,"name":"Faizah Muhamad Zin","orcid":null,"position":10,"is_corresponding":false},{"id":1252307,"name":"Samha Bashirah Mohamed Amin","orcid":null,"position":11,"is_corresponding":false},{"id":1252308,"name":"Mastura Ismail","orcid":null,"position":12,"is_corresponding":false},{"id":1252309,"name":"Azah Abdul Samad","orcid":null,"position":13,"is_corresponding":false},{"id":266015,"name":"Kalaiarasu M. Peariasamy","orcid":"0000-0001-9279-3498","position":14,"is_corresponding":false},{"id":1251906,"name":"Ee Vien Low","orcid":"0000-0001-8596-1318","position":0,"is_corresponding":true}],"reference_count":14,"raw_metadata":null,"created_at":"2026-07-19T02:00:57.233748Z","pmid":"38727886","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}