Abstract
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.
Similar content being viewed by others
References
Kumpulainen V, Makela M. Influenza vaccination among healthy employees: a cost–benefit analysis. Scand J Infect Dis 1997; 29: 181–5.
Schoenbaum SC, McNeil BJ, Kavet J. The swine-influenza decision. N Engl J Med 1976; 8: 94–9.
Meier CR, Napalkov PN, Wegemüller Y, Jefferson T, Jick H. Population-based study on incidence, risk factors, clinical complications and drug utilisation associated with influenza in the United Kingdom. Eur J Clin Microbiol Infect Dis 2000; 19: 834–42.
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.
Diggory P, Fernandez C, Humphrey A, Jones V, Murphy M. Comparison of elderly people’s technique in using two dry powder inhalers to deliver zanamivir: randomised controlled trial. BMJ 2001; 322: 1–4.
Samuelsson S, editor. Influenzavaccination 2002/2003. [Influenza vaccination 2002/2003.] EPI-NYT (39) 2002.
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.
Treanor JJ, Hayden FG, Vrooman PS, Barbarash R, Bettis R, Riff D et al. Efficacy and Safety of the oralneuraminidase inhibitor oseltamivir in treating acute influenza. JAMA 2000; 283: 1016–24.
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).
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.
Osborne R, Hawthorne G. Measurement of rapid changes in health outcomes in people with influenza symptoms. J Outcomes Res 2000; 4: 15–30.
MVH Group. The measurement and valuation of health: final report on the modelling of valuation tariffs. York University, UK: Centre for Health Economics, 1995.
Summary of product characteristics. 5.1. http://www. eudra. org/humandocs/Humans/EPAR/tamiflu/tamiflu.htm (9 August 2003).
(PLO) Praktiserende Lægers Landsorganisation. Honorartabellen. [Fee table for GPs.] www.dadlnet.dk (15 March 2002).
Lægemiddelstyrelsen. Specialitetstaksten, uge 10/11. [Specialities price list, week 10/11.] Copenhagen: Lægemiddelstyrelsen, 2002.
Lægemiddelkataloget. [Medicine formulary.] Copenhagen: Dansk Lægemiddel Information, 2000.
Sundhedsministeriet. Takstsystem 2002, Vejledning. [Fee system 2002, instruction.] Albertslund, Denmark: Schultz Grafisk, 2001.
Statistics Denmark. Statistisk årbog 2001. [Statistical yearbook 2001.] Copenhagen: Danmarks Statistik, 2001.
Simonsen L, Fukuda K, Schonberger LB, Cox NJ. The impact of influenza epidemics on hospitalisation. J Infect Dis 2000; 181(3): 831–7.
Thompson WW, Shay DK, Weintraub E, Brammer L, Cox N, Anderson LJ et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003; 289: 179–86.
(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.
Die Spitäler der Schweiz. H+ Spitalstatistiken, Medizinische Gesamtstatistik der Schweizer Spitäler 1996. [Medical statistics of the Swiss hospitals 1996.] Aarau, Switzerland: H+ Verlag, 1997.
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).
(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).
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.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Holm, M.V., Gyldmark, M. & Hansen, E.H. Pharmacoeconomic assessment of oseltamivir in treating influenza – the case of otherwise healthy Danish adolescents and adults. Pharm World Sci 26, 339–345 (2004). https://doi.org/10.1007/s11096-004-0559-2
Issue Date:
DOI: https://doi.org/10.1007/s11096-004-0559-2