Outcomes and Costs of Favipiravir, Molnupiravir, Remdesivir and Andrographis paniculata during the COVID-19 Outbreak, Kut Chum District, Yasothon Province

Abstract

The treatment of COVID-19 with medications is still a subject that requires ongoing monitoring and further research to confirm the efficacy and effectiveness of the drugs. The results and costs of COVID-19 treatment medications in the hospital’s database can be utilized in decision-making for treatment planning and hospital policy. However, there is still a lack of analysis regarding the results and costs of these medications. The objective of this study was to evaluate the efficacy and cost of favipiravir, molnupiravir, remdesivir, and Andrographis paniculata during the COVID-19 outbreak. A retrospective study was conducted on the treatment data of COVID-19 patients at Kudchum Hospital, Yasothon province, between March and June 2022 (2565 B.E.). The study analyzed clinical outcomes and the cost of medications, as well as the total cost, in patients infected with COVID-19 who received favipiravir, molnupiravir, remdesivir, and Andrographis paniculata. The analysis included patients who received outpatient treatment with self-isolation at home (out-patient with self isolation/home isolation, OPSI/HI) and patients treated with hospital admission. The results of the treatment were analyzed using multiple logistic regression, and the cost of treatment was assessed using the Kruskall-Wallis test. It was found that the majority of patients were female with an average age of 48 years. A total of 4,114 patients received outpatient self-isolation (OPSI) and home isolation (HI) treatment. Fifty-four percent of them were administered favipiravir, and among the 21 admitted patients, the majority also received favipiravir. When controlling for the influence of gender, age, absence of comorbidities, and risk factors such as obesity and asthma, it was found that receiving favipiravir in OPSI and HI did not significantly affect the improvement rate compared to those receiving the placebo (OR = 1.011, 95% CI 0.381 – 1.230). The average cost of favipiravir per person per day for admitted patients was lower than the average cost of remdesivir (median of 2,883.75 THB vs. 23,804.14 THB). When calculating the proportion of total drug costs, the cost of molnupiravir accounts for 0.14%, the cost of the placebo (favipiravir) accounts for 3.87%, and the cost of favipiravir accounts for 95.99%. In conclusion, the results of this study indicated that the outcomes of the drugs molnupiravir and favipiravir in treating COVID-19 did not differ significantly in the group of patients without or with mild symptoms. However, favipiravir had a lower drug cost compared to remdesivir for admitted patients.