Influenza treatment with neuraminidase inhibitors: cost-effectiveness and cost-utility in healthy adults in the United Kingdom.
We assessed the cost-effectiveness and cost-utility of treating influenza with neuraminidase inhibitors (oseltamivir and zanamivir) from a health care payer's and societal perspective in the United Kingdom. A simulation model was developed to predict morbidity and mortality due to influenza and its specified complications, comparing neuraminidase inhibitors with usual care in an otherwise healthy adult population. Robustness of the results was tested by one-way and multiway as well as probabilistic sensitivity analyses. Treatment with either neuraminidase inhibitor results in reduced morbidity and faster return to normal activities. However, oseltamivir dominates zanamivir in cost-utility analysis due to its lower costs. Comparing oseltamivir with usual care, the costs are pound14.36 per day of normal activity gained and pound5,600 per quality-adjusted life-year gained from the healthcare payer perspective. Oseltamivir dominates usual care from the societal perspective. Treatment with oseltamivir is a cost-effective strategy for otherwise healthy adults in the UK from both the healthcare payer and societal perspective.
Sander
Beate
B
Institute for Medical Outcome Research GmbH, Lörrach, Germany. bsander@uhnres.utoronto.ca
Gyldmark
Marlene
M
Hayden
Frederick G
FG
Morris
James
J
Mueller
Elvira
E
Bergemann
Rito
R
D000081:Acetamides / Q000191:economics* / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D004791:Enzyme Inhibitors / Q000191:economics* / Q000627:therapeutic use; D006146:Guanidines / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy* / Q000201:enzymology; D008875:Middle Aged; D009439:Neuraminidase / Q000037:antagonists & inhibitors*; D053139:Oseltamivir; D011714:Pyrans / Q000191:economics* / Q000627:therapeutic use; D012794:Sialic Acids / Q000191:economics* / Q000627:therapeutic use; D006113:United Kingdom; D053243:Zanamivir
D000081:Acetamides; D000998:Antiviral Agents; D004791:Enzyme Inhibitors; D006146:Guanidines; D011714:Pyrans; D012794:Sialic Acids; D053139:Oseltamivir; D009439:Neuraminidase; D053243:Zanamivir