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Cost-effectiveness of oseltamivir treatment for children with uncomplicated seasonal influenza.
J Pediatr 2012; 160(1):67-73.e6JPed

Abstract

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+Show Affiliations

Harvard University, Cambridge, MA, USA. tlavelle@fas.harvard.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

21917267

Citation

Lavelle, Tara A., et al. "Cost-effectiveness of Oseltamivir Treatment for Children With Uncomplicated Seasonal Influenza." The Journal of Pediatrics, vol. 160, no. 1, 2012, pp. 67-73.e6.
Lavelle TA, Uyeki TM, Prosser LA. Cost-effectiveness of oseltamivir treatment for children with uncomplicated seasonal influenza. J Pediatr. 2012;160(1):67-73.e6.
Lavelle, T. A., Uyeki, T. M., & Prosser, L. A. (2012). Cost-effectiveness of oseltamivir treatment for children with uncomplicated seasonal influenza. The Journal of Pediatrics, 160(1), pp. 67-73.e6. doi:10.1016/j.jpeds.2011.07.001.
Lavelle TA, Uyeki TM, Prosser LA. Cost-effectiveness of Oseltamivir Treatment for Children With Uncomplicated Seasonal Influenza. J Pediatr. 2012;160(1):67-73.e6. PubMed PMID: 21917267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of oseltamivir treatment for children with uncomplicated seasonal influenza. AU - Lavelle,Tara A, AU - Uyeki,Timothy M, AU - Prosser,Lisa A, Y1 - 2011/09/13/ PY - 2010/10/11/received PY - 2011/05/24/revised PY - 2011/07/01/accepted PY - 2011/9/16/entrez PY - 2011/9/16/pubmed PY - 2012/2/1/medline SP - 67 EP - 73.e6 JF - The Journal of pediatrics JO - J. Pediatr. VL - 160 IS - 1 N2 - 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. SN - 1097-6833 UR - https://www.unboundmedicine.com/medline/citation/21917267/Cost_effectiveness_of_oseltamivir_treatment_for_children_with_uncomplicated_seasonal_influenza_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(11)00673-1 DB - PRIME DP - Unbound Medicine ER -