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Population-Level Strategies for Prescribing Pegylated Interferon Lambda: A Cost-effectiveness Analysis

May 10th, 2023 Professor Reza Yaesoubi: HPM 573

Abstract

Context

Although the COVID-19 caseload in the United States has decreased significantly, the need for effective treatments continues despite the existence of a few promising drugs. Recently, a phase 3 trial conducted in Brazil and Canada showed that pegylated interferon lambda (PEG-lambda) could prevent hospitalization/emergency department (ED) visits in COVID-19 patients at a level matching that of Paxlovid, the current standard of care, with no known side effects. Despite the strong evidence, the FDA is refusing to approve, or even authorize the emergency use, of PEG-lambda.

Objective

To examine the effectiveness and cost-effectiveness of five different allocation strategies of the PEG-lambda drug, stratified by vaccine status and risk for severe disease, for COVID-19 in the United States

Design

A decision tree model from a limited healthcare sector perspective, with a hypothetical COVID-19-positive, US adult population.

Main Outcome Measures

Incremental cost-effectiveness ratio (ICER) in terms of dollars per hospitalization/ED visit averted, with a willingness to pay threshold of $50-500K per hospitalization averted.

Results

Providing PEG-lambda to unvaccinated patients at high risk for severe COVID-19 was cost-saving under the scenarios considered in this model. The cost-effectiveness of other allocation strategies, including those for vaccinated adults and those at lower risk for severe COVID-19, depends on treatment cost and effectiveness, willingness to pay thresholds and hospitalization costs.

Full Report available in repository: "Rajagopalan_REPORT"

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Final Project for HPM 573: Advanced Topics in Modeling Healthcare Decisions

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