Cost-Effectiveness of Oseltamivir Treatment for Children with Uncomplicated Seasonal Influenza - 08/12/11
, Timothy M. Uyeki, MD, MPH, MPP 3, Lisa A. Prosser, PhD 4, 5
Reprint requests: Tara A. Lavelle, MS, The Center for Health Decision Science, Harvard School of Public Health, 718 Huntington Ave, 2nd floor, Boston, MA 02115.Abstract |
Objective |
To evaluate the cost-effectiveness of oseltamivir treatment for seasonal influenza in children and consider the impact of oseltamivir resistance on these findings.
Study design |
We developed a model to evaluate 1-year clinical and economic outcomes associated with 3 outpatient management strategies for unvaccinated children with influenza-like-illness: no antiviral treatment; diagnostic testing and oseltamivir treatment when positive; and empiric oseltamivir treatment. The model depicted a hypothetical non-pandemic influenza season with a 29% level of oseltamivir resistance in circulating viruses, and 14% to 54% probability of seasonal influenza with influenza-like-illness. Strategies were compared with incremental cost-effectiveness ratios.
Results |
In our primary analysis, empiric oseltamivir treatment consistently produced the greatest benefit. The incremental cost-effectiveness of this alternative, compared with testing and treating, was <$100 000 per quality-adjusted life year gained in all age groups except the oldest. The testing strategy was consistently more effective compared with no treatment and cost between $25 900 and $71 200 per quality-adjusted life year gained, depending on age. Results were sensitive to the prevalence of oseltamivir resistance in circulating viruses.
Conclusion |
Empiric oseltamivir treatment of seasonal influenza is associated with favorable cost-effectiveness ratios, particularly in children aged 1 to <12 years, but ratios are highly dependent on the prevalence of oseltamivir resistance among circulating influenza viruses.
Le texte complet de cet article est disponible en PDF.Mots-clés : 2009 H1N1, ILI, QALY, RIDT
Plan
| Supported by the Harvard/Centers for Disease Control and Prevention Joint Initiative for Vaccine Economics and National Institutes of Health (grant 5K24HD47667). T.L. was also supported by the National Library of Medicine’s Biomedical Informatics Research Training Grant (T15 LM 007092), the Novartis Health Economics and Outcomes Research Training Fellowship Award, and the National Institute of Mental Health's Research Training Grant (T32 MH019733-17). The views expressed are those of the authors and do not necessarily reflect the policies of the Centers for Disease Control and Prevention. The authors declare no conflicts of interest. |
Vol 160 - N° 1
P. 67 - janvier 2012 Retour au numéro
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