Quality of life and cost‐effectiveness of convalescent plasma compared to standard care for hospitalized COVID‐19 patients in the CONCOR‐1 trial

Abstract

AbstractBackgroundThe CONvalescent Plasma for Hospitalized Adults With COVID‐19 Respiratory Illness (CONCOR‐1) trial was a multicenter randomized controlled trial assessing convalescent plasma in hospitalized COVID‐19 patients. This study evaluates the cost‐effectiveness of convalescent plasma and its impact on quality‐of‐life to provide insight into its potential as an alternative treatment in resource‐constrained settings.MethodsIndividual patient data on health outcomes and resource utilization from the CONCOR‐1 trial were used to conduct the analysis from the Canadian public payer's perspective with a time horizon of 30 days post‐randomization. Baseline and 30‐day EQ‐5D‐5L were measured to calculate quality‐adjusted survival. All costs are presented in 2021 Canadian dollars. The base case assessed the EQ‐5D‐5L scores of hospitalized inpatients reporting at both timepoints, and a utility score of 0 was assigned for patients who died within 30 days. Costs for all patients enrolled were used. The sensitivity analysis utilizes EQ‐5D‐5L scores from the same population but only uses costs from this population.Results940 patients were randomized: 627 received CCP and 313 received standard care. The total costs were $28,716 (standard deviation, $25,380) and $24,258 ($22,939) for the convalescent plasma and standard care arms respectively. EQ‐5D‐5L scores were 0.61 in both arms (p = .85) at baseline. At 30 days, EQ‐5D‐5L scores were 0.63 and 0.64 for patients in the convalescent plasma and standard care arms, respectively (p = .46). The incremental cost was $4458 and the incremental quality‐adjusted life day was −0.078.DiscussionConvalescent plasma was less effective and more costly than standard care in treating hospitalized COVID‐19.