Effect of Influenza Treatment with Oseltamivir on Health Outcome and Costs in Otherwise Healthy Children
- 26 Downloads
To evaluate the effect of treating children with influenza with oseltamivir on health outcomes and costs to healthcare payers.
Patients and design
Health outcome data from the oseltamivir paediatric clinical development programme plus data from the literature were used in an economic model developed to predict morbidity and mortality due to influenza and its specified complications. Published data on the cost of care in the UK were used to compare oseltamivir with usual care in children aged 1–12 and 1–5 years by estimating cost-effectiveness and cost-utility ratios.
Oseltamivir reduced median time to return to normal health and activity by almost 2 days (40% reduction, 67.1 vs 111.7 hours; p < 0.0001) versus placebo. In children aged 1–5 years, a 48% reduction (63.5 vs 121.3 hours; p = 0.0003) was observed. Oseltamivir-treated children who developed otitis media returned to normal health and activity 30% faster (99.6 vs 141.5 hours; p = 0.0517) than the placebo group. In the economic model, oseltamivir in the base-case analysis (assuming 60% diagnostic accuracy, full compliance, and 100% receive and start treatment within 48 hours, standard discounting according to the UK National Institute of Clinical Excellence guidelines) resulted in favourable cost-utility ratios in children aged both 1–12 and 1–5 years, with incremental cost-utility rates of £11 173/quality-adjusted life year (QALY) and oseltamivir being dominant compared with usual care, respectively (year of costing, 2002). Even in conservative scenarios, most cost-utility ratios remained <£30 000/QALY.
Oseltamivir is an effective treatment for children with influenza, allowing faster return to normal health and activity compared with usual care. From the healthcare payer perspective, oseltamivir is a potentially cost-effective strategy for otherwise healthy children.
- 5.Nicholson KG. Human influenza. In: Nicholson KG, Webster RG, Hay AJ, eds. Textbook of influenza. Oxford, UK: Blackwell, 1998: 219–64Google Scholar
- 20.Martin C, Mahoney P, Ward P. Oral oseltamivir reduces febrile illness in patients considered at high risk of influenza complications. Int Congr Ser. 1219: 807-811. Osterhaus A, Cox N, Hampson A, editors. World Congress on Options for the Control of Influenza IV, Crete, Greece, 2000 Sep 23-28Google Scholar
- 24.National Institute for Clinical Excellence. Guidance for manufacturers and sponsors. London: Technological Appraisals Process Series 5, 2001Google Scholar
- 28.Die Spitäler der Schweiz. H+ Spitalstatistiken, Medizinische Gesamtstatistik der Schweizer Spitäler 1996. H+ Verlag CH-5001 Aarau, 1997Google Scholar
- 29.Netten A, Rees T, Harrison G. Unit costs of health and social care. Personal Social Services Research Unit at the University of Kent at Canterbury, the London School of Economics and the University of Manchester. Canterbury, UK, University of Kent at Canterbury, 2001 Dec. Available from URL: http//www.ukc.ac.uk/PSSRU [Accessed 2002 Feb]Google Scholar
- 30.British National Formulary No . British Medical Association & Royal Pharmaceutical Society of Great Britain. Available from URL: http//www.bnf.org [Accessed 2001 Nov]Google Scholar
- 31.Department of Health and Human Services. National Ambulatory Medical Care Survey (NAMCS). National Center for Health Statistics NCHS 1997. Available from URL: http//www.cdc.gov/nchs/about/major/ahcd/namcsdes.htm [Accessed 2002 Feb]Google Scholar
- 33.Stouthard M, Essink-Bot M, Bonsel G, et al. Disability weights for diseases in the Netherlands. Department of Public Health, Erasmus University, Rotterdam, The Netherlands: 1997Google Scholar
- 34.National Institute for Clinical Excellence. Guidance on the use of zanamivir (Relenza) in the treatment of influenza. NICE Technology Appraisal Guidance -No 15. Ref: 22603. London: NICE, 2000 Nov. Available from URL: http://www.nice.org.uk and http://www.nice.org.uk/pdf/NiceZANAMIVIR15guidance.pdf [Accessed 2002 Feb]
- 38.Watanabe A, Kobayashi M. Socioeconomic analysis of oseltamivir for influenza patients. Jpn J Chemother 2001; 49: 95–102Google Scholar
- 39.Armstrong E, Khan Z, Perry A, et al. The cost effectiveness of zanamivir and oseltamivir for influenza treatment. Formulary 2000; 35: 979–89Google Scholar
- 40.Burls A, Clark W, Stewart T, et al. Zanamivir for the treatment of influenza in adults [Draft]. Commissioned by National Health Service Health Technology Assessment Programme on behalf of National Institute for Clinical Excellence. West Midlands Development and Evaluation Service, University of Birmingham; 2000 Jun. Available from URL: http://www.nice.org.uk/pdf/zanamivirtreatment.pdf [Accessed 2002 Feb]
- 41.Hussereau DR, Brady B, McGeer A. Oseltamivir for the treatment of suspected influenza: a clinical and economic assessment. Canadian Coordinating Office for Health Technology Assessment, 2001 Nov. Available from URL: http://www.cchota.ca [Accessed 2002 Feb]
- 44.Brady B, McAuley L, Shukla VK. Economic evaluation of zanamivir for the treatment of influenza. Canadian Coordinating Office for Health Technology Assessment, 2001 Nov. Available from URL: http://www.cchota.ca [Accessed 2002 Feb]
- 45.Sander B, Gyldmark M. Impact of different methods of QALY calculations on CUA results and decision-making -the case of influenza treatment with neuraminidase inhibitors. Eur J Health Econ. In pressGoogle Scholar