Marino, Kristelito Grace S.

Ph-3B

Pharmacoeconomic Analysis of Treatment Regimens for Coronavirus Infection

Coronavirus Disease-19

The article entitled, “Pharmacoeconomic Analysis of Treatment Regimens for Coronavirus

Infection Coronavirus Disease-19” by Olga Krylova, et al. aims to address the lack of medications
with proven effectiveness and safety against COVID-19 infection, and determine the best
treatment option. This is performed by conducting a pharmacoeconomic analysis of the treatment
regimens for said disease, as recommended by the Russian Federation’s Ministry of Health. Given
the prestigious affiliations of the authors, it only makes sense that they are carrying out a study in
the perspective of pharmacoeconomics and pharmacoepidemiology, and that would be of benefit
to the resolution of said problem in Russia. It is also worth noting that the publishing of this study
was particularly significant at the time, as Russia ranked fourth in the prevalence of COVID-19
infection. Therefore, the results and conclusion of this study has provided benefit in terms of
identifying which medications proved to be cost-effective.

Hydroxycloroquine

This study has determined that Hydroxychloroquine was the most appropriate medication
to provide in mild to moderate infections—however, this is only basing from an economic
viewpoint. Still, it has been recognized as ineffective against COVID-19 infections, which makes
this option insignificant.

Remdesivir

In hospital setting, this medication was determined to be the most expensive and least cost-
effective for mild to moderate infections. Compared to Favipiravir, this has a lesser observed effect
for the patients, whilst being expensive at the same time.

Favipiravir

It has been established that Favipiravir is the most effective medication for moderate and
severe COVID-19 infections. According to the cost-effectiveness analysis, this drug also has a
remarkable cost-effectiveness ratio compared to both Remdesivir and Umifenovir, with their CER
having a distinctive gap as well. It is worth noting though, that while Favipiravir has been proven
to be effective for the mild form of COVID-19 infection, it is not as cost-effective and affordable
as Umifenovir.

Umifenovir

This study determined that Umifenovir, despite having lower effectiveness, it is still
appropriate and effective for the mild infection of COVID-19. This medication can be concluded
as the most cost-effective medication out of all the medications considered. This is only based on
the pharmacoeconomic aspect of the medication, not including the effectiveness analysis.

As the comparisons for the medications were presented, the study’s methods made use of
the three (3) cost categories for inpatient settings, in order to conclude which of the drugs under
consideration were the most cost-effective and able to deliver its therapeutic effect. These cost
categories include the direct medical cost, direct non-medical cost, and the indirect cost. In terms
of outpatient setting, the cost of individual medications was calculated using pharmacy average
prices in Moscow, Russia alone. Aside from this, several clinical trials, cost-effectiveness and cost
of illness researches were also presented to support the conclusions provided.

To sum up everything, the study was able to support said arguments. However, it is quite
lacking that the scope of this study was limited in the city of Moscow. Considering the geography
of Russia, it is only a small portion of the state. Also, it is only applicable for the urban areas where
the prices may have similarities in Moscow. It failed to consider the smaller areas of Russia, which
may have a different cost of illness and therapy. It is also important to mention that while there are
adequate evidences that Favipiravir was the most effective and cost-efficient out of all the three
medications, it may be appropriate to compare Umifenovir versus Remdesivir, to further provide
some insight and clarity on their pharmacoeconomic stance. Then again, this study can be a good
reference in understanding the best treatment option for COVID-19 that is economically feasible.