1. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness: economic evaluation alongside the randomised controlled ALIC 4 E trial in 15 European countries.
- Author
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Li X, Bilcke J, van der Velden AW, Bruyndonckx R, Coenen S, Bongard E, de Paor M, Chlabicz S, Godycki-Cwirko M, Francis N, Aabenhus R, Bucher HC, Colliers A, De Sutter A, Garcia-Sangenis A, Glinz D, Harbin NJ, Kosiek K, Lindbæk M, Lionis C, Llor C, Mikó-Pauer R, Radzeviciene Jurgute R, Seifert B, Sundvall PD, Touboul Lundgren P, Tsakountakis N, Verheij TJ, Goossens H, Butler CC, and Beutels P
- Subjects
- Adolescent, Adult, Child, Humans, Cost-Benefit Analysis, Oseltamivir therapeutic use, Quality of Life, Europe, Quality-Adjusted Life Years, Primary Health Care, Influenza, Human drug therapy, Virus Diseases
- Abstract
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., (© 2022. The Author(s).)
- Published
- 2023
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