Summary: | Letermovir is an antiviral agent that can be administered orally or intravenously at a dosage of 480 mg daily (or 240 mg daily if co-administered with cyclosporine A) in patients undergoing an allogeneic hematopoietic stem cell transplant (HSCT) as prophylaxis of cytomegalovirus (CMV) infection. The recommended treatment regimen, as per the Health Canada-approved product monograph, is initiation of letermovir on the day of HSCT or up to 28 days post-transplant and continued through 100 days post-HSCT. At the manufacturer's submitted price ($251.28 for the oral formulations and the 240 mg intravenous [IV] vial, $493.78 for the 480 mg IV vial), the average daily drug cost ranges from $251.28 to $493.78. The average cost per treatment, assuming a treatment course of 100 days, ranges from $25,128 to $49,378 per patient. The manufacturer submitted a cost-utility analysis comparing letermovir as prophylaxis of CMV infection, taken alongside usual care, in adult (50.8 years old) CMV-seropositive HSCT recipients compared with usual care alone
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