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Bedside rapid flu test and zanamivir prescription in healthy working adults: a cost-benefit analysis.
Pharmacoeconomics. 2003; 21(3):215-24.P

Abstract

BACKGROUND

Zanamivir, a neuraminidase inhibitor, reduces the number of days of illness in influenza-positive patients. New bedside rapid flu tests (RFT) should increase the number of influenza-positive patients whom receive zanamivir appropriately.

OBJECTIVE

To estimate the economic effects of implementing RFT and zanamivir among unvaccinated healthy working adults who consult within 2 days of the onset of influenza-like symptoms.

METHODS

We constructed a decision tree to perform a cost-benefit analysis from a societal perspective. Clinical outcome, i.e. number of influenza days averted, and societal costs were compared for three strategies: RFT and conditional zanamivir prescription;systematic zanamivir prescription; and no zanamivir. A two-way sensitivity analysis was performed including the proportion of influenza-positive patients.

RESULTS

During influenza epidemics, systematic zanamivir prescription provided the best health outcome (0.81 influenza days averted) and minimised societal costs (reduced by 29.80 US dollars per person compared with no zanamivir; 1999 values). RFT with conditional zanamivir averted 0.65 influenza days and saved 14.40 US dollars per person. When the proportion of influenza-positive patients was under 39%, the no zanamivir strategy yielded the greatest societal savings; otherwise, systematic zanamivir was the dominant strategy. Medical costs associated with no zanamivir were 88.70 US dollars per patient consulting with influenza-like illness, and increased to 125.50 US dollars with systematic zanamivir and to 127.60 US dollars with RFT and conditional zanamivir.

CONCLUSIONS

Due to poor sensitivity of current RFT, systematic zanamivir prescription without RFT for unvaccinated healthy working adults should be recommended during influenza epidemics.

Authors+Show Affiliations

Institut National de la Santé Et de la Recherche Médicale, u444, Hôpital Saint-Antoine, Paris, France. schwarzi@u44.jussieu.frNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12558471

Citation

Schwarzinger, Michaël, et al. "Bedside Rapid Flu Test and Zanamivir Prescription in Healthy Working Adults: a Cost-benefit Analysis." PharmacoEconomics, vol. 21, no. 3, 2003, pp. 215-24.
Schwarzinger M, Housset B, Carrat F. Bedside rapid flu test and zanamivir prescription in healthy working adults: a cost-benefit analysis. Pharmacoeconomics. 2003;21(3):215-24.
Schwarzinger, M., Housset, B., & Carrat, F. (2003). Bedside rapid flu test and zanamivir prescription in healthy working adults: a cost-benefit analysis. PharmacoEconomics, 21(3), 215-24.
Schwarzinger M, Housset B, Carrat F. Bedside Rapid Flu Test and Zanamivir Prescription in Healthy Working Adults: a Cost-benefit Analysis. Pharmacoeconomics. 2003;21(3):215-24. PubMed PMID: 12558471.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bedside rapid flu test and zanamivir prescription in healthy working adults: a cost-benefit analysis. AU - Schwarzinger,Michaël, AU - Housset,Bruno, AU - Carrat,Fabrice, PY - 2003/2/1/pubmed PY - 2003/4/4/medline PY - 2003/2/1/entrez SP - 215 EP - 24 JF - PharmacoEconomics JO - Pharmacoeconomics VL - 21 IS - 3 N2 - BACKGROUND: Zanamivir, a neuraminidase inhibitor, reduces the number of days of illness in influenza-positive patients. New bedside rapid flu tests (RFT) should increase the number of influenza-positive patients whom receive zanamivir appropriately. OBJECTIVE: To estimate the economic effects of implementing RFT and zanamivir among unvaccinated healthy working adults who consult within 2 days of the onset of influenza-like symptoms. METHODS: We constructed a decision tree to perform a cost-benefit analysis from a societal perspective. Clinical outcome, i.e. number of influenza days averted, and societal costs were compared for three strategies: RFT and conditional zanamivir prescription;systematic zanamivir prescription; and no zanamivir. A two-way sensitivity analysis was performed including the proportion of influenza-positive patients. RESULTS: During influenza epidemics, systematic zanamivir prescription provided the best health outcome (0.81 influenza days averted) and minimised societal costs (reduced by 29.80 US dollars per person compared with no zanamivir; 1999 values). RFT with conditional zanamivir averted 0.65 influenza days and saved 14.40 US dollars per person. When the proportion of influenza-positive patients was under 39%, the no zanamivir strategy yielded the greatest societal savings; otherwise, systematic zanamivir was the dominant strategy. Medical costs associated with no zanamivir were 88.70 US dollars per patient consulting with influenza-like illness, and increased to 125.50 US dollars with systematic zanamivir and to 127.60 US dollars with RFT and conditional zanamivir. CONCLUSIONS: Due to poor sensitivity of current RFT, systematic zanamivir prescription without RFT for unvaccinated healthy working adults should be recommended during influenza epidemics. SN - 1170-7690 UR - https://www.unboundmedicine.com/medline/citation/12558471/Bedside_rapid_flu_test_and_zanamivir_prescription_in_healthy_working_adults:_a_cost_benefit_analysis_ L2 - https://dx.doi.org/10.2165/00019053-200321030-00006 DB - PRIME DP - Unbound Medicine ER -