Oseltamivir use in an Influenza Outbreak: Linking Pharmacology to Pharmacoeconomics
Methods: We simulated the infected population across a 1 year seasonal influenza outbreak using a health economic model linked to a PK/PD-epidemiology model (SEIR). Different scenarios were considered to evaluate the cost-effectiveness of high dose (150mg BID) vs standard dose (75mg BID) oseltamivir, low and high virulence, varying transmissibility (low and high attack rates (37% and 67.5% respectively)) and drug uptake (25%, 50%, and 80%). The analysis was conducted from a societal perspective, incorporating both direct and indirect costs. Disease epidemiology and costs were US-specific. Sensitivity analyses were performed to test model robustness.
Results: Results for incremental cost, deaths averted, quality-adjusted life-years (QALY) gained, and incremental cost-effectiveness ratios (ICERs) for high dose compared with standard dose oseltamivir under different scenarios are given in Table.
|Comparators (150 mg vs. 75 mg)||Incremental cost (USD)3||Death averted||QALY gained||ICER(per QALY)|
1 Proportion of infected cases who visited ED was assumed to be twice as high as in low severity scenario 2 Uptake 3negative signs mean cost-saving
Conclusion: These results suggest the potential for high dose oseltamivir to provide economic value, and may have a role in pandemic influenza particularly in high transmissability scenarios; the role of high dose oseltamivir should be investigated further.
Roche: Grant Investigator, Consulting fee and Research grant
C. Pratoomsoot, Roche: Collaborator, Research grant and Research support
K. Lee, Roche: Consultant, Consulting fee
H. C. Yi, Roche: Research Contractor, Research grant and Research support
R. E. Nelson, Roche: Consultant and Grant Investigator, Consulting fee, Research grant and Research support
P. Smith, Roche: Grant Investigator, Consulting fee
C. Kirkpatrick, Roche: Consultant, Consulting fee
M. Kamal, Roche: Employee, Salary
K. Nieforth, Roche: Consultant, Consulting fee
G. Dall, Roche: Consultant, Consulting fee
S. Toovey, Roche: Consultant, Consulting fee
D. Kong, Roche: Consultant, Consulting fee
A. Kamauu, Roche: Consultant and Grant Investigator, Consulting fee and Research support
C. Rayner, Roche: Research Contractor, Consulting fee