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Special assessment of outpatient treatments for COVID-19: nirmatrelvir/ritonavir (Paxlovid) health-benefit price benchmark update
Special assessment of outpatient treatments for COVID-19: nirmatrelvir/ritonavir (Paxlovid) health-benefit price benchmark update
In May 2022, the Institute for Clinical and Economic Review (ICER) published a special assessment of several emerging outpatient treatment options for COVID-19. Since that time, the drug nirmatrelvir/ritonavir (Paxlovid, Pfizer) has become the leading treatment option. In addition, since May 2022, the viral epidemiology of COVID-19 has continued to evolve, increasing numbers of Americans have either been vaccinated and/or gained increased immunity from prior infections, and further evidence has been published on the relative effectiveness of treatment. It is also anticipated that in early-mid 2023 the payment for Paxlovid for many patients will begin to shift from prior federal contracts over to new pricing and payment arrangements negotiated between Pfizer and commercial insurers. Although dominant viral variants, vaccination/prior infection status, and evidence on Paxlovid will continue to evolve, and some questions, such as the relative impact on long COVID are still highly uncertain, we are presenting an update to our calculations of a health-benefit price benchmark range for Paxlovid at this time to help inform new discussions on fair pricing for the dominant outpatient treatment option for COVID-19.
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