{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:00:05Z","timestamp":1768456805700,"version":"3.49.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Evaluate the impact of acute care formulary addition of nirmatrelvir-ritonavir (NMV\/r) on both economic and clinical outcomes among elderly hospitalized patients with mild-to-moderate COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>This retrospective, multi-site cohort study included patients aged \u226570\u2005years hospitalized with mild-to-moderate COVID-19 who received NMV\/r or remdesivir (RDV) between March and December 2024. The primary outcome was drug-acquisition cost avoidance attributed to NMV\/r formulary availability. Secondary outcomes included progression to severe disease, acute care treatment duration, hospital length of stay (LOS), ICU admission, 30-day readmission and 28-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 100 patients (50 per group) with mild-moderate COVID-19, NMV\/r use produced an estimated US$66\u200a197 in cost avoidance, corresponding to $1324\u200a\u00b1\u200a$678 per patient (95% CI $1136\u2013$1512). The total hospitalization cost difference between the groups was $461\u200a511 in favour of NMV\/r. NMV\/r prescribing was more common for mild COVID-19 (23 of 50 versus 12 of 50, P\u200a=\u200a0.021) while RDV prescribing was more common for moderate COVID-19 (27 of 50 versus 38 of 50, P\u200a=\u200a0.021). Patients in the NMV\/r group had lower rates of disease progression (22% versus 46%, P\u200a=\u200a0.02), shorter acute care treatment duration (2 versus 3\u2005days, P\u200a&amp;lt;\u200a0.01) and shorter hospital LOS (2 versus 4\u2005days, P\u200a&amp;lt;\u200a0.01). No adverse events leading to discontinuation were observed in either group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Economic data from this study of elderly adults with mild-moderate COVID-19 suggest that addition of NMV\/r to hospital formulary should be considered to support optimal resources consumption, while the clinical impact of NMV\/r availability may be better studied through evaluating mild or moderate COVID-19 disease independently.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf448","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T12:56:38Z","timestamp":1764075398000},"source":"Crossref","is-referenced-by-count":0,"title":["Nirmatrelvir-ritonavir addition to acute care formulary: a retrospective, multi-centre evaluation of quantitative economic and qualitative clinical outcomes"],"prefix":"10.1093","volume":"81","author":[{"given":"Jose","family":"Valdes Ledesma","sequence":"first","affiliation":[{"name":"Inpatient Pharmacy Department, Baptist Hospital of Miami , 8900 N Kendall Drive, Miami, FL 33176 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5863-9935","authenticated-orcid":false,"given":"Jefferson","family":"Cua","sequence":"additional","affiliation":[{"name":"Inpatient Pharmacy Department, Baptist Hospital of Miami , 8900 N Kendall Drive, Miami, FL 33176 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0631-6261","authenticated-orcid":false,"given":"Lourdes R","family":"Menendez Alvarado","sequence":"additional","affiliation":[{"name":"Inpatient Pharmacy Department, Baptist Hospital of Miami , 8900 N Kendall Drive, Miami, FL 33176 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