Pfizer’s oral COVID-19 drug Paxlovid would achieve cost-effectiveness if priced between $563 to $906 per treatment course, according to data released by the Institute for Clinical and Economic Review (ICER) this week.
In the spring, ICER estimated that the health benefit price benchmark for Paxlovid was between $3,600 to $5,800, with a treatment course price of $529, which excludes administration, monitoring, or markup-related costs.
ICER’s health benefit price benchmark is a price range outlining the highest price a manufacturer should charge for a treatment based on the amount of overall health improvement in patients who receive the treatment.
ICER stated that the decrease compared to the initial health benefit price benchmark is associated with evidence suggesting lower risks for hospitalizations among untreated patients as well as a lower relative reduction in hospitalization with the drug.
“As hospitalization rates due to COVID-19 rise or fall in the future due to changes in the COVID-19 landscape, the clinical value of Paxlovid will change accordingly,” ICER President Steven Pearson, MD, MSc said in a statement. “Nonetheless, with substantial new data now available from recent experience during the Omicron wave earlier this year, and with new negotiations underway on pricing and payment between commercial insurers and the manufacturer, we believe it will be helpful for all stakeholders to have updated calculations of a price that aligns with the evidence on benefits to patients.”
The organization added that the strongest reason for an updated assessment was due to the release of new COVID-19 data from the Centers for Disease Control and Prevention earlier this month.
The Paxlovid price update was released just weeks before the U.S. government plans to stop paying for the treatment on behalf of Americans, nearly 6 million of whom have already received the treatment.
As the government winds down its purchasing of COVID treatments like Paxlovid, it will be incumbent upon pharmacies to purchase supplies of the drug just like they do with other medicines. By mid-2023, it’s expected that pricing and payment arrangements between Pfizer and commercial payers will replace federal contracts for many patients.
Access to the drug has been an issue for many Americans since its rollout.
This comes at a time when the drug’s effects on seniors have been profound, though the same can’t necessarily be said for younger adults, according to research. Additionally, a recent Paxlovid study found that even patients who weren’t immunized still received benefits.