Inclusion of anti-Covid pills in SUS can generate savings of R$ 19 billion

In addition to expanding treatment alternatives against Covid-19, the use of the drugs nirmatrelvir and ritonavir in non-hospitalized patients can generate savings of up to R$19 billion to public coffers over a period of five years.

The value takes into account the difference between the estimated cost of treatment with the drugs and the expenses caused by hospitalization (from moderate cases to those requiring an intensive care unit, when this value increases exponentially) and by scenarios with low and high incidence of infected.

The National Commission for the Incorporation of Technologies to the Unified Health System (Conitec) analyzes the possibility of including the use of these drugs in the treatment alternatives against Covid-19 in Brazil. On Wednesday (27/4), the group closed the public consultation on the subject.

The commission’s next step is to send the Ministry of Health a favorable recommendation for the administration of drugs.

It will be up to the Secretary of Science, Technology, Innovation and Strategic Inputs of the portfolio, Sandra de Castro Barros, to approve or not the use of medicines. If so, the drugs will be included in the list of therapies of the Unified Health System (SUS).

The drugs are indicated for home use in adults with early symptoms of the disease. The drug should be taken for five days, right after the first symptoms and/or positive result for the Covid-19 test. The effect of the pill blocks the replication of the virus and prevents the progression of the disease to serious conditions.

Studies carried out by Pfizer show that the drugs reduced the risk of hospitalization or death for patients who used the drug between the third and fifth days of symptoms of the disease, with almost 89% effectiveness.

cost-effectiveness

To carry out the cost-effectiveness analysis of the pills, Conitec considered patients aged 65 years or older and immunosuppressed. According to the commission, Pfizer proposed a cost of US$ 250 per treatment with Paxlovid, equivalent to R$ 1,252, according to the Central Bank (at the March 9, 2022 quotation, the date on which the commission evaluated the cost-effectiveness ).

The value is lower than the average cost of hospitalization of patients with Covid-19 in the ward, which, added to the expenses with dialysis, diagnosis, laboratory and imaging tests, is estimated at R$ 6,358.76. In cases of hospitalization in the Intensive Care Center (ICU), the cost rises to R$ 51,467.30.

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Treatments for Covid-19 may vary according to the table presented. In milder cases, where there is muscle pain, headache, loss of taste or smell, intense cough and fever, rest and the use of certain medications can help relieve symptoms. MSD/Play

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In more serious cases, in which the patient has difficulty breathing or has chest pain, hospital treatment is necessary.Walrus Images/ Getty Images

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In Brazil, some drugs were authorized by Anvisa as a treatment for Covid-19. One of them is baricitinib, which is strongly recommended for patients with severe cases of infection, as it increases the likelihood of survival from the complications that the coronavirus can cause.Rafaela Felicciano / Metropolis

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The drug works by decreasing the damage caused by the coronavirus to cells and decreases inflammation. It is supplied in the form of 2 mg or 4 mg tablets and should only be used with a doctor’s prescription.Aitor Diago/ Getty Images

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The monoclonal antibody sotrovimab is another drug authorized by the regulatory agency as a treatment for Covid-19. However, it is only indicated for mild cases of the disease and should be used when the first symptoms appear.Paul Bradbury/Getty Images

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According to the pharmaceutical company GSK, sotrovimab is effective against mutations of the coronavirus, as well as those that characterize the Ômicron variant. The drug is injectable and its use is restricted to hospitals.EThamPhoto/Getty Images

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Dexamethasone, a corticosteroid, is another authorized treatment. According to studies, the drug is indicated for patients with severe conditions. It is able to reduce mortality only when the use of oxygen is necessary.Jackyenjoyphotography/ Getty Images

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Despite being indicated by health agencies, corticosteroids should not be used without medical advice, as it can worsen the clinical picture if used early.Nitat Termmee/Getty Images

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Anvisa also granted permission for the use of the REGN-COV antibody cocktail. Treatment is indicated for people who are showing the first symptoms of the disease and do not need hospitalization, but who are at greater risk of developing serious conditions.Yulia-Images/ Getty Images

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For the use of the cocktail, which contains two monoclonal antibodies, casirivimab and imdevimab, a medical prescription is required. It is applied via intravenous infusion and, according to the manufacturer, reduces the risk of hospitalization or death by up to 70%. In severe cases, the drug should not be used, as it may worsen the condition.FG Trade / Getty Images

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Like corticosteroids, interleukin-6 receptor blockers are also indicated to treat severe symptoms of Covid-19, as they reduce death from the disease. However, for the use of the drug, a medical prescription is necessary, as misuse can worsen the patient’s condition.Walrus Images/ Getty Images

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All medicines authorized by the National Health Surveillance Agency are for restricted hospital use and are treatments for people who have coronavirus. To date, no drug has been shown to be effective in preventing infection with the disease. Geber86/ Getty Images

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As the group’s report points out, if the average risk of hospitalization of 34% for patients with Covid-19 is considered, the eventual use of Paxlovid can generate savings for public coffers, budgeted in an amount between R$ 2 billion (in scenarios with low incidence of infections by the new coronavirus) and R$ 19 billion (in contexts with a high number of cases), in a period of five years.

Acquisition of medication

The federal government plans to enter into a purchase agreement with Pfizer, the maker of the drugs, which are offered commercially under the name Paxlovid.

To make the agreement official, however, the Ministry of Health awaits the conclusion of the analysis at Conitec. The Minister of Health, Marcelo Queiroga, has already signaled that the acquisition of the drug must be completed.

Covid-19 in the country

As of Thursday (28/4), Brazil had lost 663,225 lives to the coronavirus. The country has already accounted for 30,418,920 accumulated cases since the beginning of the pandemic. The data are included in the most recent balance released by the National Council of Health Secretaries (Conass).

With 114 deaths recorded on Thursday, the average number of deaths per day is 102. The number represents a drop of 8% compared to 14 days ago.

According to the Ministry of Health, there are 29,480,998 Brazilians recovered from the pandemic disease.

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