The Impact of Tocilizumab Coverage on Health Equity for Inpatients with COVID-19 in the USA: A Distributional Cost-Effectiveness Analysis.

The Impact of Tocilizumab Coverage on Health Equity for Inpatients with COVID-19 in the USA: A Distributional Cost-Effectiveness Analysis.

Publication date: Oct 10, 2024

We conducted a distributional cost-effectiveness analysis to evaluate how coverage of tocilizumab for inpatients with COVID-19 from 2021 to present impacted health equity in the USA. A published, payer-perspective, distributional cost-effectiveness analysis for inpatient COVID-19 treatments was adapted to include information on baseline health disparities across 25 equity-relevant subgroups based on race and ethnicity (5 census-based groups), and county-level social vulnerability (5 geographic quintiles). The underlying cost-effectiveness analysis was updated to reflect patient characteristics at admission, standard of care outcomes, tocilizumab efficacy, and contemporary unit costs. The distributional cost-effectiveness analysis inputs for COVID-19 hospitalization and subgroup risk adjustments based on social vulnerability were derived from published estimates. Opportunity costs were estimated by converting total tocilizumab spend into quality-adjusted life-years (QALYs), distributed equally across subgroups. Tocilizumab treatment was cost effective across all subgroups. Treatment resulted in larger relative QALY gains in more socially vulnerable subgroups than less socially vulnerable subgroups, given higher hospitalization rates and inpatient mortality. Using an opportunity cost threshold of US$150,000/QALY and an Atkinson index of 11, tocilizumab was estimated to have improved social welfare by increasing population health (53,252 QALYs gained) and reducing existing overall US health inequalities by 0. 003% since 2021. Use of tocilizumab for COVID-19 since 2021 increased population health while improving health equity, as more patients with lower baseline health were eligible for treatment and received larger relative health gains. Future equitable access to tocilizumab for inpatients with COVID-19 is expected to lead to continued increases in population health and reductions in disparities.

Open Access PDF

Concepts Keywords
Inpatients Based
Pharmacoeconomics Cost
Tocilizumab Covid
Distributional
Effectiveness
Equity
Inpatient
Inpatients
Population
Published
Social
Subgroups
Tocilizumab
Treatment
Usa

Semantics

Type Source Name
drug DRUGBANK Tocilizumab
disease MESH COVID-19
disease MESH health disparities
disease MESH social vulnerability
disease IDO quality
drug DRUGBANK Coenzyme M
disease MESH Emergency
drug DRUGBANK Oxygen
drug DRUGBANK Pentaerythritol tetranitrate
drug DRUGBANK Trestolone
disease MESH death
drug DRUGBANK Nonoxynol-9
disease IDO intervention
disease MESH weight gains
drug DRUGBANK Ethionamide
drug DRUGBANK Alpha-1-proteinase inhibitor
disease MESH Minority Health
drug DRUGBANK Aspartame
drug DRUGBANK Esomeprazole
drug DRUGBANK Stavudine
disease IDO country
pathway REACTOME Reproduction
disease MESH lung cancer
disease MESH chronic conditions
disease IDO algorithm
disease MESH syndrome

Original Article

(Visited 2 times, 1 visits today)

Leave a Comment

Your email address will not be published. Required fields are marked *