Table 1.
Incremental cost-effectiveness of molnupiravir with usual care versus usual care over 6 months of base-case, sensitivity, selected subgroup, and post hoc subgroup analyses, in 2020/2021 £ prices
| Analysis category | Molnupiravir: usual care, n | Mean cost (SE) | Incremental cost (bootstrap 95% CI) | Mean QALYs (SE) | Incremental QALYs (bootstrap 95% CI) | ICER, £/QALY | Probability of molnupiravir being cost-effective at specified cost-effectiveness threshold | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
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| Molnupiravir | Usual care | Molnupiravir | Usual care | £15 000 | £20 000 | £30 000 | |||||
| Base-case analysisa | 12 821:12 962 | 1808 (1.5) | 1359 (1.5) | 449 (445 to 453) | 0.4136 (0.0004) | 0.4080 (0.0004) | 0.0055 (0.0044 to 0.0067) | 81 190 (NE quad) | <0.001 | <0.001 | <0.001 |
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| Sensitivity analysesa | |||||||||||
| Societal perspective | 12 821:12 962 | 2202 (2.6) | 1861 (2.6) | 341 (334 to 348) | 0.4136 (0.0004) | 0.4080 (0.0004) | 0.0055 (0.0044 to 0.0067) | 61 714 (NE quad) | <0.001 | <0.001 | <0.001 |
| Complete cases | 7822:6984 | 1385 (2.8) | 800 (3.0) | 586 (578 to 594) | 0.4197 (0.0006) | 0.4180 (0.0006) | 0.0017 (0.0001 to 0.0034) | 340 986 (NE quad) | <0.001 | <0.001 | <0.001 |
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| Subgroup analysesa | |||||||||||
| Age, years, with 80 years as cut-off | |||||||||||
| <80 | 12 562:12 690 | 1793 (1.3) | 1340 (1.3) | 454 (450 to 457) | 0.4142 (0.0004) | 0.4088 (0.0004) | 0.0054 (0.0043 to 0.0065) | 83 838 (NE quad) | <0.001 | <0.001 | <0.001 |
| ≥80 | 259:272 | 2524 (26.2) | 2276 (27.3) | 248 (176 to 322) | 0.3812 (0.0038) | 0.3715 (0.0036) | 0.0097 (−0.0006 to 0.020) | 25 521 (NE quad) | 0.39 | 0.44 | 0.54 |
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| Immune disorders | |||||||||||
| No | 11 696:11 892 | 1730 (0.8) | 1308 (0.8) | 422 (419 to 424) | 0.4168 (0.0004) | 0.4106 (0.0004) | 0.0063 (0.0052 to 0.0074) | 67 052 (NE quad) | <0.001 | <0.001 | <0.001 |
| Yes | 1125:1070 | 2621 (2.2) | 1927 (2.8) | 694 (686 to 701) | 0.3793 (0.0017) | 0.3799 (0.0017) | −0.0006 (−0.0052 to 0.0042) | Dominated (NW quad) | <0.001 | <0.001 | <0.001 |
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| Doses of vaccination | |||||||||||
| 0 | 143:132 | 2197 (27.0) | 1569 (29.4) | 628 (550 to 704) | 0.3760 (0.0037) | 0.3750 (0.0042) | 0.001 (−0.0099 to 0.012) | 610 155 (NE quad) | 0.012 | 0.022 | 0.052 |
| 1 | 87:88 | 2548 (46.7) | 1576 (45.4) | 972 (846 to 1097) | 0.3760 (0.0059) | 0.3734 (0.0049) | 0.0026 (−0.013 to 0.018) | 378 798 (NE quad) | 0.020 | 0.028 | 0.053 |
| 2 | 519:458 | 2206 (14.6) | 1759 (16.5) | 448 (405 to 492) | 0.3793 (0.0023) | 0.3760 (0.0025) | 0.0033 (−0.0033 to 0.0099) | 134 388 (NE quad) | 0.015 | 0.025 | 0.059 |
| 3 | 11 836:12 044 | 1772 (1.3) | 1330 (1.3) | 443 (439 to 446) | 0.4163 (0.0004) | 0.4101 (0.0004) | 0.0062 (0.0051 to 0.0074) | 70 839 (NE quad) | <0.001 | <0.001 | <0.001 |
| ≥4 | 236:240 | 2196 (26.4) | 1871 (28.5) | 325 (251 to 401) | 0.3855 (0.0037) | 0.3962 (0.0035) | −0.011 (−0.021 to −0.0007) | Dominated (NW quad) | 0.091 | 0.077 | 0.059 |
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| NHS priority category | |||||||||||
| Category 2: Aged ≥80 years | 259:272 | 2524 (16.4) | 2276 (16.6) | 248 (201 to 294) | 0.3812 (0.0039) | 0.3715 (0.0037) | 0.0097 (−0.0009 to 0.020) | 25 521 (NE quad) | 0.39 | 0.44 | 0.54 |
| Category 3: Aged ≥75 and <80 years | 540:577 | 1651 (4.9) | 1432 (4.8) | 219 (206 to 233) | 0.4165 (0.0015) | 0.4083 (0.0015) | 0.0082 (0.0039 to 0.013) | 26 787 (NE quad) | 0.28 | 0.37 | 0.55 |
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| Post hoc subgroup analysisa | 799:849 | 1934 (12.2) | 1702 (12.1) | 232 (199 to 265) | 0.4050 (0.0017) | 0.3965 (0.0016) | 0.0085 (0.0039 to 0.013) | 27 129 (NE quad) | 0.26 | 0.36 | 0.55 |
a
All base-case, sensitivity, and subgroup analyses were adjusted using age, vaccination status, and comorbidity unless stated otherwise. Post hoc subgroup analysis and age groups were adjusted by vaccination status and comorbidity. NHS priority category was adjusted by age and vaccination status. Number of doses of vaccination was adjusted by age and comorbidity. ICER = incremental cost-effectiveness ratio. NE = North-East. NW = North-West. QALY = quality-adjusted life year. Quad = quadrant of the cost-effectiveness plane. SE = standard error.