Pharmacoeconomic assessment of oseltamivir in treating influenza – the case of otherwise healthy Danish adolescents and adults
Objective: To assess the pharmacoeconomics of treating influenza with oseltamivir in healthy Danish adolescents and adults.
Method: Cost-effectiveness and cost-utility analyses were used to compare oseltamivir to usual care (symptomatic treatment with over the counter (OTC) medicine), considering both the societal and health care payer’s perspectives. The population group studied was otherwise healthy adolescents and adults, aged 13 to 64. Danish data were collected to simulate results that are specific to Denmark. The economic model included first- and second-order Monte Carlo simulations. Sensitivity analyses were conducted to test the robustness of the analyses.
Main outcome measure: The cost-effectiveness study was expressed as gain in cost per day to return to normal activity, and the cost-utility study as cost per QALY (quality adjusted life years) gained.
Results: From a societal perspective, oseltamivir was a dominant treatment compared to usual care. From a health care payer’s perspective, the cost-effectiveness ratio was |CE 12.3 per gain in day to return to normal activity and |CE 5,063 /QALY gained. A sensitivity analysis leaving out hospitalisation, complications, and mortality showed increased cost-effectiveness and cost-utility ratios. However, treatment with oseltamivir remained cost-effective, assuming a willingness to pay for health benefits at |CE 26,174/QALY.
Conclusion: Pharmacoeconomic analyses of influenza treatment with oseltamivir in an otherwise healthy Danish adolescent/adult population show that this treatment saves money for society and is associated with a relatively low cost from a health care payer’s perspective. Treatment of influenza with oseltamivir would be cost-effective for healthy adolescents/adults in Denmark.
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- 1.Kumpulainen V, Makela M. Influenza vaccination among healthy employees: a cost–benefit analysis. Scand J Infect Dis 1997; 29: 181–5.Google Scholar
- 2.Schoenbaum SC, McNeil BJ, Kavet J. The swine-influenza decision. N Engl J Med 1976; 8: 94–9.Google Scholar
- 4.Keech M, Scott AJ, Ryan PJ. The impact of influenza and influenza-like illness on productivity and healthcare resource utilization in a working population. Occup Med (Lond) 1998; 48: 85–90.Google Scholar
- 6.Samuelsson S, editor. Influenzavaccination 2002/2003. [Influenza vaccination 2002/2003.] EPI-NYT (39) 2002.Google Scholar
- 7.Sander B, Gyldmark M, Morris J. Influenza treatment with oseltamivir in an otherwise healthy population – a cost effective option for the health care payer. Poster presented at 24th Annual Meeting of the Society for Medical Decision Making. Baltimore, Maryland, 2002, Poster Abstract ID 90.Google Scholar
- 9.Statistics Denmark. Statistikbanken [StatBank]. AB121D: Ledige i pct. af arbejdsstyrken [Unemployed in percent of workforce.] 2002/3. www.statistikbanken.dk/statbank5a/selecout/print.asp (16 December 2002).Google Scholar
- 10.Stouthard M, Essink-Bot M, Bonsel G, Barendregt JJ, van de Water HPA, Gunning-Schepers LJ et al. Disability weights for diseases in the Netherlands. Rotterdam, The Netherlands: Department of Public Health, Erasmus University Rotterdam, 1997.Google Scholar
- 11.Osborne R, Hawthorne G. Measurement of rapid changes in health outcomes in people with influenza symptoms. J Outcomes Res 2000; 4: 15–30.Google Scholar
- 12.MVH Group. The measurement and valuation of health: final report on the modelling of valuation tariffs. York University, UK: Centre for Health Economics, 1995.Google Scholar
- 13.Summary of product characteristics. 5.1. http://www. eudra. org/humandocs/Humans/EPAR/tamiflu/tamiflu.htm (9 August 2003).Google Scholar
- 14.(PLO) Praktiserende Lægers Landsorganisation. Honorartabellen. [Fee table for GPs.] www.dadlnet.dk (15 March 2002).Google Scholar
- 15.Lægemiddelstyrelsen. Specialitetstaksten, uge 10/11. [Specialities price list, week 10/11.] Copenhagen: Lægemiddelstyrelsen, 2002.Google Scholar
- 16.Lægemiddelkataloget. [Medicine formulary.] Copenhagen: Dansk Lægemiddel Information, 2000.Google Scholar
- 17.Sundhedsministeriet. Takstsystem 2002, Vejledning. [Fee system 2002, instruction.] Albertslund, Denmark: Schultz Grafisk, 2001.Google Scholar
- 18.Statistics Denmark. Statistisk årbog 2001. [Statistical yearbook 2001.] Copenhagen: Danmarks Statistik, 2001.Google Scholar
- 21.(MTV) Statens Institut for Medicinsk Teknologivurdering. Medicinsk problemstilling i MTV-perspektiv. Penicillinbehandling ved pneumoni: oralt eller intravenøst? [Medical problems in a HTA perspective. Penicillin treatment of pneumonia: Oral or intravenously?] Albertslund, Denmark: c/o Schultz Information, 2000.Google Scholar
- 22.Die Spitäler der Schweiz. H+ Spitalstatistiken, Medizinische Gesamtstatistik der Schweizer Spitäler 1996. [Medical statistics of the Swiss hospitals 1996.] Aarau, Switzerland: H+ Verlag, 1997.Google Scholar
- 23.Finansministeriet. Vejledning i udarbejdelse af samfundsøkonomiske konsekvensvurderinger. Kapitel 3. [Ministry of Finance. Guidance for conduction of societal economic consequence assessments. Chapter 3.] Finansministeriet. November 1999. www.fm.dk/udgivelser/publikationer/vejlsamf99/appb.htm (1 August 2001).Google Scholar
- 24.(MTV) Statens Institut for Medicinsk Teknologivurdering. [Danish Centre for Evaluation and Health Technology Assessment.] Influenza vaccination af ældre [Influenza vaccination of the elderly]. Medicinsk Teknologivurdering 2000; 2(1).Google Scholar
- 25.Dillon A, editor. Final appraisal document. Zanamivir, oseltamivir and amantadine for the treatment and prophylaxis of influenza. London: NICE (National Institut for Clinical Excellence), 2002.Google Scholar