OBJECTIVE: To evaluate the cost-effectiveness of oseltamivir treatment for seasonal influenza in children and consider the impact of oseltamivir resistance on these findings. STUDY DESIGN: We developed a model to evaluate 1-year clinical and economic outcomes associated with 3 outpatient management strategies for unvaccinated children with influenza-like-illness: no antiviral treatment; diagnostic testing and oseltamivir treatment when positive; and empiric oseltamivir treatment. The model depicted a hypothetical non-pandemic influenza season with a 29% level of oseltamivir resistance in circulating viruses, and 14% to 54% probability of seasonal influenza with influenza-like-illness. Strategies were compared with incremental cost-effectiveness ratios. RESULTS: In our primary analysis, empiric oseltamivir treatment consistently produced the greatest benefit. The incremental cost-effectiveness of this alternative, compared with testing and treating, was <$100,000 per quality-adjusted life year gained in all age groups except the oldest. The testing strategy was consistently more effective compared with no treatment and cost between $25,900 and $71,200 per quality-adjusted life year gained, depending on age. Results were sensitive to the prevalence of oseltamivir resistance in circulating viruses. CONCLUSION: Empiric oseltamivir treatment of seasonal influenza is associated with favorable cost-effectiveness ratios, particularly in children aged 1 to <12 years, but ratios are highly dependent on the prevalence of oseltamivir resistance among circulating influenza viruses.
OBJECTIVE: To evaluate the cost-effectiveness of oseltamivir treatment for seasonal influenza in children and consider the impact of oseltamivir resistance on these findings. STUDY DESIGN: We developed a model to evaluate 1-year clinical and economic outcomes associated with 3 outpatient management strategies for unvaccinated children with influenza-like-illness: no antiviral treatment; diagnostic testing and oseltamivir treatment when positive; and empiric oseltamivir treatment. The model depicted a hypothetical non-pandemic influenza season with a 29% level of oseltamivir resistance in circulating viruses, and 14% to 54% probability of seasonal influenza with influenza-like-illness. Strategies were compared with incremental cost-effectiveness ratios. RESULTS: In our primary analysis, empiric oseltamivir treatment consistently produced the greatest benefit. The incremental cost-effectiveness of this alternative, compared with testing and treating, was <$100,000 per quality-adjusted life year gained in all age groups except the oldest. The testing strategy was consistently more effective compared with no treatment and cost between $25,900 and $71,200 per quality-adjusted life year gained, depending on age. Results were sensitive to the prevalence of oseltamivir resistance in circulating viruses. CONCLUSION: Empiric oseltamivir treatment of seasonal influenza is associated with favorable cost-effectiveness ratios, particularly in children aged 1 to <12 years, but ratios are highly dependent on the prevalence of oseltamivir resistance among circulating influenza viruses.
Authors: Kenneth J Smith; Jonathan M Raviotta; Jay V DePasse; Shawn T Brown; Eunha Shim; Mary Patricia Nowalk; Richard K Zimmerman Journal: Am J Prev Med Date: 2016-02-08 Impact factor: 5.043
Authors: Rebecca J Hart; Michelle D Stevenson; Michael J Smith; A Scott LaJoie; Keith Cross Journal: JAMA Pediatr Date: 2018-01-02 Impact factor: 16.193
Authors: L Gayani Tillekeratne; Champica Bodinayake; Ajith Nagahawatte; Ruvini Kurukulasooriya; Lori A Orlando; Ryan A Simmons; Lawrence P Park; Christopher W Woods; Shelby D Reed Journal: BMJ Glob Health Date: 2019-03-30
Authors: Simon van der Pol; Paula Rojas Garcia; Maarten J Postma; Fernando Antoñanzas Villar; Antoinette D I van Asselt Journal: Pharmacoeconomics Date: 2021-07-15 Impact factor: 4.981