Hovilpri (pritelivir)

No published budget impact model, cost-effectiveness analysis, or health technology assessment of pritelivir has been identified. The FDA approved pritelivir on 9 October 2026, the manufacturer expects availability in the United States before the end of 2026, and no published wholesale acquisition cost (WAC) has been identified. The one figure identified is a market research assumption in a 2025 AiCuris corporate presentation: a monthly per-patient WAC in the United States of approximately $30,000, assuming a 28-day treatment course. The labeled dose is 400 mg on day 1, then 100 mg once daily until the lesions have healed. In the trial the label describes, treatment lasted up to 28 days, or up to 42 days when lesions were improving; the mean duration among 51 participants was 27.1 days, and 33% extended treatment up to 42 days. The label lists cartons of 16 and 32 tablets.

For the eligible population, Asahi Kasei estimates approximately 180,000 people in the United States at first-line treatment and 15,000 at second-line treatment, based on an internal investigation. A 2024 AiCuris presentation gives a different company estimate, 27,200 severely immunocompromised people with acyclovir resistance in the United States. Published figures include a 0.4% incidence of laboratory-confirmed acyclovir-resistant infection among 4,028 allogeneic transplants at one center and, in a 2025 review, resistance rates of often 0% to 14% in hematopoietic cell transplant recipients. For the comparator, a cohort from 7 United States transplant centers reports 109 foscarnet courses of a mean 21.8 days in a hospital or hospital-associated infusion clinic, a 5-center cohort reports a median of 16 days, and a single-center cohort reports hospitalization in 9 of 18 recipients (50%). The fourth-quarter 2026 Medicare Clinical Laboratory Fee Schedule lists $26.07 and $20.20 for the codes of the Labcorp phenotypic resistance test and $35.09 and $130.35 for the codes of the University of Washington genotypic tests. This report holds no cost study of refractory infection, no foscarnet course cost, and no payment limit.