Cost effectiveness of oseltamivir treatment for patients with influenza-like illness who are at increased risk for serious complications of influenza: illustration for the Netherlands.
BACKGROUND
Oseltamivir is effective in the treatment of influenza. Utilisation in The Netherlands is limited, but increasing.


OBJECTIVE
To estimate the cost effectiveness of oseltamivir treatment (vs symptom relief only) for patients with influenza-like illness (ILI) who are at increased risk for serious complications of influenza.


METHODS
A cost-effectiveness analysis was used, building on a previously developed model (decision tree) that was applied for evaluating influenza vaccination and pandemic preparedness plans. Three patient subgroups were assessed (elderly patients [aged > or = 65 years] without chronic disease, elderly patients with chronic disease, and chronically ill, non-elderly patients). Inputs for the model were taken from various sources including a meta-analysis. A societal perspective was adopted and costs were expressed in euro per life-year gained (year 2003 values). Life-years lost were discounted at 4% in accordance with Dutch guidelines. Deterministic and probabilistic sensitivity analyses were employed to assess the robustness of the results.


RESULTS
For chronically ill patients with ILI, visits to the GP for oseltamivir treatment were cost saving. For non-chronically ill elderly patients, incremental cost-effectiveness was estimated at 1759 euros per life-year gained. Cost savings and favourable cost effectiveness were robust in a deterministic and stochastic sensitivity analysis.


CONCLUSIONS
Our model-based analysis suggests that at-risk people presenting with ILI to a GP could be offered oseltamivir at favourable cost effectiveness or even cost savings in the Dutch setting compared with symptom relief with analgesics only.
Postma
Maarten J
MJ
Graduate Schools SHARE and GUIDE, Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Groningen, The Netherlands. m.j.postma@rug.nl
Novak
Annoesjka
A
Scheijbeler
Huib W K F H
HW
Gyldmark
Marlene
M
van Genugten
Marianne L L
ML
Wilschut
Jan C
JC
D000368:Aged; D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use*; D002908:Chronic Disease; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D008297:Male; D018803:Models, Economic; D009426:Netherlands / Q000453:epidemiology; D053139:Oseltamivir / Q000191:economics* / Q000627:therapeutic use*; D012306:Risk
D000998:Antiviral Agents; D053139:Oseltamivir