Evidence map›Paper›PMID 38228357›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2024

Cost-utility analysis of molnupiravir for high-risk, community-based adults with COVID-19: an economic evaluation of the PANORAMIC trial.

May Ee Png, Victoria Harris, Jenna Grabey, Nigel D Hart, Bhautesh D Jani, Daniel Butler, Andrew Carson-Stevens, Maria Coates, Lucy Cureton, Melissa Dobson and 23 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors at 11 institutions in 5 countries.

May Ee PngNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-5876-9363
Victoria HarrisNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-3345-2826
Jenna GrabeyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-7498-1276
Nigel D HartDentistry and Biomedical Sciences, Queen's University Belfast, UK.ORCID 0000-0002-8168-1746
Bhautesh D JaniGeneral Practice and Primary Care, School of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow.ORCID 0000-0001-7348-514X
Daniel ButlerDentistry and Biomedical Sciences, Queen's University Belfast, UK.ORCID 0000-0001-8539-4181
Andrew Carson-StevensDivision of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.ORCID 0000-0002-7580-7699
Maria CoatesNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Lucy CuretonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-0082-8468
Melissa DobsonOxford Respiratory Trials Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0002-4906-3956
Jienchi DorwardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.ORCID 0000-0001-6072-1430
Philip EvansFaculty of Health and Life Sciences, University of Exeter, Exeter, UK; National Institute for Health and Care Research (NIHR) Clinical Research Network, University of Leeds, Leeds, UK.ORCID 0000-0002-5277-3545
Nick FrancisPrimary Care Research Centre, University of Southampton, Southampton, UK.ORCID 0000-0001-8939-7312
Oghenekome A GbinigieNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-2963-4491
Gail HaywardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-0852-627X
Jane HolmesNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-7123-0004
Kerenza HoodCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0002-5268-8631
Saye KhooDepartment of Pharmacology, University of Liverpool, Liverpool, UK.ORCID 0000-0002-2769-0967
Haroon AhmedDivision of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.ORCID 0000-0002-0634-8548
Mark LownPrimary Care Research Centre, University of Southampton, Southampton, UK.ORCID 0000-0001-8309-568X
Micheal McKennaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Sam MortNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-6332-4641
Jonathan S Nguyen-Van-TamLifespan and Population Health Unit, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0003-2579-4655
Najib M RahmanOxford Respiratory Trials Unit, Nuffield Department of Medicine, University of Oxford, Oxford; Oxford NIHR Biomedical Research Centre, Oxford; Chinese Academy of Medicial Sciences Oxford Institute, University of Oxford, Oxford, UK.ORCID 0000-0003-1195-1680
Duncan B RichardsNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-8093-7084
Nicholas Pb ThomasWitney; NIHR Thames Valley and South Midlands Clinical Research Network, UK; Royal College of General Practitioners, London, UK.ORCID 0000-0003-0460-6870
Oliver van HeckeNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-6229-5057
Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-7976-7172
Paul LittlePrimary Care Research Centre, University of Southampton, Southampton, UK.ORCID 0000-0003-3664-1873
Ly-Mee YuNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-0331-7364
Christopher C ButlerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-0102-3453
Stavros PetrouNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-3121-6050
PANORAMIC Trial Collaborators
University of Oxford · GBCardiff University · GBNIHR Southampton Biomedical Research Centre · GBQueen's University Belfast · GBCentre for the AIDS Programme of Research in South Africa · ZANational Institute for Health Research · GBNuffield Orthopaedic Centre · GBUniversity of Exeter · GBUniversity of Glasgow · GBUniversity of Liverpool · GBUniversity of Nottingham · GB

Funding

Marie Curie MCCC-FCO-11-CMarie Curie MCCC-RP-14-A17178Medical Research Council G0600475Medical Research Council G1001128
6 · The paper itself

Abstract

backgroundThe cost-effectiveness of molnupiravir, an oral antiviral for early treatment of SARS-CoV-2, has not been established in vaccinated populations.

aimTo evaluate the cost-effectiveness of molnupiravir relative to usual care alone among mainly vaccinated community-based people at higher risk of severe outcomes from COVID-19 over 6 months. DESIGN AND

settingAn economic evaluation of the PANORAMIC trial in the UK.

methodA cost-utility analysis that adopted a UK NHS and personal social services perspective and a 6-month time horizon was performed using PANORAMIC trial data. Cost-effectiveness was expressed in terms of incremental cost per quality-adjusted life year (QALY) gained. Sensitivity and subgroup analyses assessed the impacts of uncertainty and heterogeneity. Threshold analysis explored the price for molnupiravir consistent with likely reimbursement.

resultsIn the base-case analysis, molnupiravir had higher mean costs of £449 (95% confidence interval [CI] = 445 to 453) and higher mean QALYs of 0.0055 (95% CI = 0.0044 to 0.0067) than usual care (mean incremental cost per QALY of £81 190). Sensitivity and subgroup analyses showed similar results, except for those aged ≥75 years, with a 55% probability of being cost-effective at a £30 000 per QALY threshold. Molnupiravir would have to be priced around £147 per course to be cost-effective at a £15 000 per QALY threshold.

conclusionAt the current cost of £513 per course, molnupiravir is unlikely to be cost-effective relative to usual care over a 6-month time horizon among mainly vaccinated patients with COVID-19 at increased risk of adverse outcomes, except those aged ≥75 years.

Indexed as

Antiviral AgentsCost-Benefit AnalysisCOVID-19 Drug TreatmentCytidineHydroxylaminesQuality-Adjusted Life YearsSARS-CoV-2AdultCOVID-19FemaleHumansMaleMiddle AgedUnited KingdomAntiviral AgentsCytidineHydroxylaminesmolnupiravirantiviral drugscost-benefit analysisCOVID-19molnupiravirquality-adjusted life yearsSARS-CoV-2

Identifiers

PMID38228357
PMCPMC11257071
OpenAlexW4390913180

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.