Cost-effectiveness of antiviral stockpiling and near-patient testing for potential influenza pandemic.
A decision analytical model was developed to investigate the cost-effectiveness of stockpiling antiviral (AV) drugs for a potential influenza pandemic in the United Kingdom and the possible role of near-patient testing in conserving AV drug stocks. Under base-case assumptions (including a fixed stockpile that was smaller than the clinical attack rate), the treat-only option (treating all symptomatic patients with AV drugs) would be considered cost-effective ( pound1,900- pound13,700 per quality-adjusted life year [QALY] gained, depending on the fatality scenario), compared with no intervention (nonintervention but management of cases as they arise). The test-treat option (testing all symptomatic patients but treating those with positive tests results only) would result in moderate gains in QALYs over the treat-only option but at relatively large additional costs. Stockpiling sufficient AV drugs (but not near-patient tests) to treat all patients with clinical cases would be cost-effective, provided AV drugs are effective at preventing deaths from pandemic influenza.
Siddiqui
M Ruby
MR
Health Protection Agency, London, UK. ruby.siddiqui@hpa.org.uk
Edmunds
W John
WJ
D000998:Antiviral Agents / Q000191:economics / Q000600:supply & distribution* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D004196:Disease Outbreaks / Q000517:prevention & control; D017048:Health Care Costs; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D019057:Quality-Adjusted Life Years; D012680:Sensitivity and Specificity
D000998:Antiviral Agents