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Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness: economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries
X. Li, J. Bilcke, AW. van der Velden, R. Bruyndonckx, S. Coenen, E. Bongard, M. de Paor, S. Chlabicz, M. Godycki-Cwirko, N. Francis, R. Aabenhus, HC. Bucher, A. Colliers, A. De Sutter, A. Garcia-Sangenis, D. Glinz, NJ. Harbin, K. Kosiek, M....
Language English Country Germany
Document type Journal Article
Grant support
grant HEALTH-F3-2013-602525
European Commission
NLK
ProQuest Central
from 2001 to 1 year ago
Medline Complete (EBSCOhost)
from 2002-03-01 to 1 year ago
Health & Medicine (ProQuest)
from 2001 to 1 year ago
Health Management Database (ProQuest)
from 2001 to 1 year ago
Public Health Database (ProQuest)
from 2001 to 1 year ago
- MeSH
- Cost-Benefit Analysis MeSH
- Influenza, Human * drug therapy MeSH
- Child MeSH
- Adult MeSH
- Quality of Life MeSH
- Quality-Adjusted Life Years MeSH
- Humans MeSH
- Adolescent MeSH
- Oseltamivir therapeutic use MeSH
- Primary Health Care MeSH
- Virus Diseases * MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
BACKGROUND: Oseltamivir is usually not often prescribed (or reimbursed) for non-high-risk patients consulting for influenza-like-illness (ILI) in primary care in Europe. We aimed to evaluate the cost-effectiveness of adding oseltamivir to usual primary care in adults/adolescents (13 years +) and children with ILI during seasonal influenza epidemics, using data collected in an open-label, multi-season, randomised controlled trial of oseltamivir in 15 European countries. METHODS: Direct and indirect cost estimates were based on patient reported resource use and official country-specific unit costs. Health-Related Quality of Life was assessed by EQ-5D questionnaires. Costs and quality adjusted life-years (QALY) were bootstrapped (N = 10,000) to estimate incremental cost-effectiveness ratios (ICER), from both the healthcare payers' and the societal perspectives, with uncertainty expressed through probabilistic sensitivity analysis and expected value for perfect information (EVPI) analysis. Additionally, scenario (self-reported spending), comorbidities subgroup and country-specific analyses were performed. RESULTS: The healthcare payers' expected ICERs of oseltamivir were €22,459 per QALY gained in adults/adolescents and €13,001 in children. From the societal perspective, oseltamivir was cost-saving in adults/adolescents, but the ICER is €8,344 in children. Large uncertainties were observed in subgroups with comorbidities, especially for children. The expected ICERs and extent of decision uncertainty varied between countries (EVPI ranged €1-€35 per patient). CONCLUSION: Adding oseltamivir to primary usual care in Europe is likely to be cost-effective for treating adults/adolescents and children with ILI from the healthcare payers' perspective (if willingness-to-pay per QALY gained > €22,459) and cost-saving in adults/adolescents from a societal perspective.
Centre for Family and Community Medicine Medical University of Lodz Lodz Poland
Département de Santé Publique Hôpital de l'Archet Nice France
Department of Family Medicine and Population Health University of Antwerp Antwerp Belgium
Department of Family Medicine Medical University of Bialystok Białystok Poland
Department of Public Health and Primary Care Gent University Gent Belgium
DRC Drug Research Center LLC Balatonfüred Hungary
Family Doctors' Clinic Lodz Poland
FDC Mano šeimos gydytojas Klaipeda Lithuania
General Practice and Primary Health Care at the School of Medicine University of Crete Crete Greece
Julius Center for Health Sciences and Primary Care University Medical Center Utrecht The Netherlands
Malia Surgery Kastelli HC Heraklio Greece
RCSI Department of General Practice 123 St Stephens Green Dublin 2 Ireland
The Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK
University Institute in Primary Care Research Jordi Gol Via Roma Health Centre Barcelona Spain
References provided by Crossref.org
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