Evaluation of patient outcomes after implementation of remdesivir restriction criteria
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Publication Date
4-29-2026
Keywords
oregon, psvmc, psvmc pharmacy gme
Disciplines
Medical Education
Abstract
Abstract: Remdesivir has demonstrated inconsistent clinical benefit in randomized trials, with the greatest efficacy observed in hospitalized patients requiring low-flow oxygen and no clear mortality benefit in patients requiring invasive mechanical ventilation. In the era of widespread SARS-CoV-2 immunity, evolving viral variants, and reduced disease severity, the role of routine remdesivir use remains uncertain. Continued prescribing may expose patients to unnecessary therapy, prolong hospitalization, and increase healthcare costs without clear incremental benefit. In June 2025, Providence Oregon hospitals implemented restriction criteria limiting remdesivir use to selected high-risk populations, including elderly, immunocompromised, or critically ill patients presenting within seven days of symptom onset. The purpose of this study is to evaluate the clinical and financial impact of implementing remdesivir restriction criteria across Providence Oregon hospitals. This study is a multi-center retrospective cohort analysis of adult patients hospitalized with nasopharyngeal PCR confirmed SARS-CoV-2 identified through the electronic medical record. Patients hospitalized at one of eight Providence Oregon hospitals between July 15, 2024 and October 15, 2024 (pre-restriction period) and July 15, 2025 and October 15, 2025 (post restriction period) were included to allow comparison of outcomes before and after the intervention. Demographic, clinical, and treatment data were collected through chart review. Variables collected include age, sex, body mass index, race or ethnicity, oxygen saturation, oxygen device, baseline vital signs, immunocompromised status, comorbidities, days from symptom onset, intensive care unit admission status, medications (corticosteroids, remdesivir, and antibiotics), vaccination status, prior SARS-CoV-2 infection, and presence of sepsis at admission. The primary outcome is the need for supplemental oxygen or escalation in home oxygen therapy requirements. Secondary outcomes include hospital length of stay, intensive care unit admission, mechanical ventilation, 30-day readmission, in-hospital mortality, adherence to the restriction policy, and financial impact associated with remdesivir utilization. Continuous variables will be analyzed using Student’s t-test or Mann-Whitney U test, and categorical variables will be analyzed using chi-square or Fisher’s exact tests as appropriate. Results and conclusions will be shared when the project is completed. (IRB exempt) Learning Objective: Assess the clinical and financial impact of recently implemented remdesivir restriction criteria. Presentation Category: Infectious Diseases
Specialty/Research Institute
Graduate Medical Education
Specialty/Research Institute
Pharmacy
