Lok Wong Samson

The Center for Medicare and Medicaid Innovation (CMS Innovation Center) was established under the Affordable Care Act for the purpose of testing “innovative payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care.” Through rigorous testing, evidence development, and feedback mechanisms, the CMS Innovation Center has the potential to positively influence spending, quality, and value for model participants and beyond.

This report examines the utilization of oral antiviral medications, Paxlovid and Lagevrio, for the treatment of COVID-19. The analyses include an examination of time trends of COVID-19 antiviral use as well as breakdowns by age cohorts and gender. The report finds that utilization in the U.S. of both Paxlovid and Lagevrio rose sharply in the spring of 2022, rising more than tenfold for all age groups between March and July 2022.

Publication Date May 4, 2022 Using Medicare FFS claims data and county-level vaccination rates, we estimate savings of about $2.6 billion from reduced Medicare hospitalizations associated with COVID-19 vaccinations in early 2021. These cost savings reflect 107,000 fewer Medicare (FFS and Medicare Advantage) COVID-19 hospitalizations during this period, compared to projections if no COVID-19 vaccines were available during that period.