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Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis.
PLoS One. 2016; 11(4):e0153664.Plos

Abstract

BACKGROUND

Influenza is a common viral respiratory infection that causes epidemics and pandemics in the human population. Oseltamivir is a neuraminidase inhibitor-a new class of antiviral therapy for influenza. Although its efficacy and safety have been established, there is uncertainty regarding whether influenza-like illness (ILI) in children is best managed by oseltamivir at the onset of illness, and its cost-effectiveness in children has not been studied in China.

OBJECTIVE

To evaluate the cost-effectiveness of post rapid influenza diagnostic test (RIDT) treatment with oseltamivir and empiric treatment with oseltamivir comparing with no antiviral therapy against influenza for children with ILI.

METHODS

We developed a decision-analytic model based on previously published evidence to simulate and evaluate 1-year potential clinical and economic outcomes associated with three managing strategies for children presenting with symptoms of influenza. Model inputs were derived from literature and expert opinion of clinical practice and research in China. Outcome measures included costs and quality-adjusted life year (QALY). All the interventions were compared with incremental cost-effectiveness ratios (ICER).

RESULTS

In base case analysis, empiric treatment with oseltamivir consistently produced the greatest gains in QALY. When compared with no antiviral therapy, the empiric treatment with oseltamivir strategy is very cost effective with an ICER of RMB 4,438. When compared with the post RIDT treatment with oseltamivir, the empiric treatment with oseltamivir strategy is dominant. Probabilistic sensitivity analysis projected that there is a 100% probability that empiric oseltamivir treatment would be considered as a very cost-effective strategy compared to the no antiviral therapy, according to the WHO recommendations for cost-effectiveness thresholds. The same was concluded with 99% probability for empiric oseltamivir treatment being a very cost-effective strategy compared to the post RIDT treatment with oseltamivir.

CONCLUSION

In the Chinese setting of current health system, our modelling based simulation analysis suggests that empiric treatment with oseltamivir to be a cost-saving and very cost-effective strategy in managing children with ILI.

Authors+Show Affiliations

Department of Respiratory Care, Beijing Children's Hospital, Beijing, China.Health Economics & Outcomes Research, IMS Health China, Shanghai, China.Health Economics & Outcomes Research, IMS Health Asia Pacific, Singapore, Singapore.Department of Pharmacy, The 306th Hospital of PLA, Beijing, China.

Pub Type(s)

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

Language

eng

PubMed ID

27082431

Citation

Shen, Kunling, et al. "Oseltamivir Treatment for Children With Influenza-Like Illness in China: a Cost-Effectiveness Analysis." PloS One, vol. 11, no. 4, 2016, pp. e0153664.
Shen K, Xiong T, Tan SC, et al. Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis. PLoS ONE. 2016;11(4):e0153664.
Shen, K., Xiong, T., Tan, S. C., & Wu, J. (2016). Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis. PloS One, 11(4), e0153664. https://doi.org/10.1371/journal.pone.0153664
Shen K, et al. Oseltamivir Treatment for Children With Influenza-Like Illness in China: a Cost-Effectiveness Analysis. PLoS ONE. 2016;11(4):e0153664. PubMed PMID: 27082431.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis. AU - Shen,Kunling, AU - Xiong,Tengbin, AU - Tan,Seng Chuen, AU - Wu,Jiuhong, Y1 - 2016/04/15/ PY - 2015/12/01/received PY - 2016/04/02/accepted PY - 2016/4/16/entrez PY - 2016/4/16/pubmed PY - 2016/9/7/medline SP - e0153664 EP - e0153664 JF - PloS one JO - PLoS ONE VL - 11 IS - 4 N2 - BACKGROUND: Influenza is a common viral respiratory infection that causes epidemics and pandemics in the human population. Oseltamivir is a neuraminidase inhibitor-a new class of antiviral therapy for influenza. Although its efficacy and safety have been established, there is uncertainty regarding whether influenza-like illness (ILI) in children is best managed by oseltamivir at the onset of illness, and its cost-effectiveness in children has not been studied in China. OBJECTIVE: To evaluate the cost-effectiveness of post rapid influenza diagnostic test (RIDT) treatment with oseltamivir and empiric treatment with oseltamivir comparing with no antiviral therapy against influenza for children with ILI. METHODS: We developed a decision-analytic model based on previously published evidence to simulate and evaluate 1-year potential clinical and economic outcomes associated with three managing strategies for children presenting with symptoms of influenza. Model inputs were derived from literature and expert opinion of clinical practice and research in China. Outcome measures included costs and quality-adjusted life year (QALY). All the interventions were compared with incremental cost-effectiveness ratios (ICER). RESULTS: In base case analysis, empiric treatment with oseltamivir consistently produced the greatest gains in QALY. When compared with no antiviral therapy, the empiric treatment with oseltamivir strategy is very cost effective with an ICER of RMB 4,438. When compared with the post RIDT treatment with oseltamivir, the empiric treatment with oseltamivir strategy is dominant. Probabilistic sensitivity analysis projected that there is a 100% probability that empiric oseltamivir treatment would be considered as a very cost-effective strategy compared to the no antiviral therapy, according to the WHO recommendations for cost-effectiveness thresholds. The same was concluded with 99% probability for empiric oseltamivir treatment being a very cost-effective strategy compared to the post RIDT treatment with oseltamivir. CONCLUSION: In the Chinese setting of current health system, our modelling based simulation analysis suggests that empiric treatment with oseltamivir to be a cost-saving and very cost-effective strategy in managing children with ILI. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/27082431/Oseltamivir_Treatment_for_Children_with_Influenza_Like_Illness_in_China:_A_Cost_Effectiveness_Analysis_ L2 - http://dx.plos.org/10.1371/journal.pone.0153664 DB - PRIME DP - Unbound Medicine ER -