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1. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness: economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries

Author

Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C., Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J., Kosiek, Katarzyna, Lindbæk, Morten, Lionis, Christos, Llor, Carl, Mikó-Pauer, Réka, Radzeviciene Jurgute, Ruta, Seifert, Bohumil, Sundvall, Pär-Daniel, Touboul Lundgren, Pia, Tsakountakis, Nikolaos, Verheij, Theo J., Goossens, Herman, Butler, Christopher C., and Beutels, Philippe

Published
2023
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4. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness:economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries

Author

Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C., Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J., Kosiek, Katarzyna, Lindbaek, Morten, Lionis, Christos, Llor, Carl, Miko-Pauer, Reka, Jurgute, Ruta Radzeviciene, Seifert, Bohumil, Sundvall, Par-Daniel, Lundgren, Pia Touboul, Tsakountakis, Nikolaos, Verheij, Theo J., Goossens, Herman, Butler, Christopher C., Beutels, Philippe, Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C., Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J., Kosiek, Katarzyna, Lindbaek, Morten, Lionis, Christos, Llor, Carl, Miko-Pauer, Reka, Jurgute, Ruta Radzeviciene, Seifert, Bohumil, Sundvall, Par-Daniel, Lundgren, Pia Touboul, Tsakountakis, Nikolaos, Verheij, Theo J., Goossens, Herman, Butler, Christopher C., and Beutels, Philippe

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 euro22,459 per QALY gained in adults/adolescents and euro13,001 in children. From the societal perspective, oseltamivir was cost-saving in adults/adolescents, but the ICER is euro8,344 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 euro1-euro35 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 > euro22,459) and cost-saving in adults/adolescents from a societal perspective.

Published
2023

5. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness: economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries.

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Li, Xiao, Bilcke, Joke, van der Velden, Alike W, Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C, Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J, Kosiek, Katarzyna, Lindbæk, Morten, Lionis, Christos, Llor, Carl, Mikó-Pauer, Réka, Radzeviciene Jurgute, Ruta, Seifert, Bohumil, Sundvall, Pär-Daniel, Touboul Lundgren, Pia, Tsakountakis, Nikolaos, Verheij, Theo J, Goossens, Herman, Butler, Christopher C, Beutels, Philippe, ALIC4Etrial investigators, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Li, Xiao, Bilcke, Joke, van der Velden, Alike W, Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C, Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J, Kosiek, Katarzyna, Lindbæk, Morten, Lionis, Christos, Llor, Carl, Mikó-Pauer, Réka, Radzeviciene Jurgute, Ruta, Seifert, Bohumil, Sundvall, Pär-Daniel, Touboul Lundgren, Pia, Tsakountakis, Nikolaos, Verheij, Theo J, Goossens, Herman, Butler, Christopher C, Beutels, Philippe, and ALIC4Etrial investigators

Published
2023

6. Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness: economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries.

Author

Li, Xiao, Bilcke, Joke, van der Velden, Alike W., Bruyndonckx, Robin, Coenen, Samuel, Bongard, Emily, de Paor, Muirrean, Chlabicz, Slawomir, Godycki-Cwirko, Maciek, Francis, Nick, Aabenhus, Rune, Bucher, Heiner C., Colliers, Annelies, De Sutter, An, Garcia-Sangenis, Ana, Glinz, Dominik, Harbin, Nicolay J., Kosiek, Katarzyna, Lindbæk, Morten, and Lionis, Christos

Subjects
RANDOMIZED controlled trials, PRIMARY care, QUALITY of life, OSELTAMIVIR, SEASONAL influenza
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. [ABSTRACT FROM AUTHOR]

Published
2023
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7. Double-blind placebo-controlled randomized clinical trial to assess the efficacy of montelukast in mild to moderate respiratory symptoms of patients with long COVID : E-SPERANZA COVID Project study protocol

Author

Mera Cordero, Francisco, Bonet Monne, Sara, Almeda, J, Garcia-Sangenis, Ana, Cunillera, O, Contreras-Martos, Sara, Álvarez Muñoz, Gemma, Monfà Escolà, Ramon, Balanzó Joué, Marina, Morros Pedrós, Rosa, Salvador-Gonzalez, Betlem, Mera Cordero, Francisco, Bonet Monne, Sara, Almeda, J, Garcia-Sangenis, Ana, Cunillera, O, Contreras-Martos, Sara, Álvarez Muñoz, Gemma, Monfà Escolà, Ramon, Balanzó Joué, Marina, Morros Pedrós, Rosa, and Salvador-Gonzalez, Betlem

Abstract

The coronavirus disease 2019 (COVID-19) pandemic continues to affect the globe. After 18 months of the SARS-CoV-2 emergence, clinicians have clearly defined a subgroup of patients with lasting, disabling symptoms. While big strides have been made in understanding the acute phase of SARS-CoV-2 infection, the pathophysiology of long COVID is still largely unknown, and evidence-based, effective treatments for this condition remain unavailable. To evaluate the efficacy of 10 mg oral montelukast every 24 h versus placebo in improving quality of life associated with mild to moderate respiratory symptoms in patients with long COVID as measured with the COPD Assessment Test (CAT) questionnaire. The secondary objectives will evaluate the effect of montelukast versus placebo on improving exercise capacity, COVID-19 symptoms (asthenia, headache, mental confusion or brain fog, ageusia, and anosmia), oxygen desaturation during exertion, functional status, and mortality. Phase III, randomized, double-blind clinical trial. We will include 18- to 80-year-old patients with SARS-CoV-2 infection and mild to moderate respiratory symptoms lasting more than 4 weeks. Participants will be randomly allocated in a 1:1 ratio to the intervention (experimental treatment with 10 mg/day montelukast) or the control group (placebo group), during a 28-day treatment. Follow-up will finish 56 days after the start of treatment. The primary outcome will be health-related quality of life associated with respiratory symptoms according to the COPD Assessment Test 4 weeks after starting the treatment. The following are the secondary outcomes: (a) exercise capacity and oxygen saturation (1-min sit-to-stand test); (b) Post-COVID-19 Functional Status Scale; (c) other symptoms: asthenia, headache, mental confusion (brain fog), ageusia, and anosmia (Likert scale); (d) use of healthcare resources; (e) mortality; (f) sick leave duration in days; and (g) side effects of montelukast. This study has been approved by

Published
2022

8. Point of care testing, antibiotic prescribing and prescribing confidence for respiratory tract infections in primary care: a prospective audit in 18 European countries

Author

HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Huisartsopleiding, Biostatistiek Onderzoek, van der Velden, Alike, van de Pol, Alma C, Bongard, Emily, Cianci, Daniela, Aabenhus, Rune, Balan, Anca, Böhmer, Femke, Bralic Lang, Valerija, Bruno, Pascale, Chlabicz, Slawomir, Coenen, Samuel, Colliers, Annelies, Garcia-Sangenis, Anna, Ghazaryan, Hrachuhi, Godycki-Cwirko, Maciek, Jensen, Siri, Lionis, Christos, van der Linde, Sanne R, Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Vellinga, Akke, Zastavnyy, Ihor, Emmerich, Susanne, Zerda, Adam, Verheij, Theo J, Goossens, Herman, Butler, Christopher C, HAG Infectieziekten, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Huisartsopleiding, Biostatistiek Onderzoek, van der Velden, Alike, van de Pol, Alma C, Bongard, Emily, Cianci, Daniela, Aabenhus, Rune, Balan, Anca, Böhmer, Femke, Bralic Lang, Valerija, Bruno, Pascale, Chlabicz, Slawomir, Coenen, Samuel, Colliers, Annelies, Garcia-Sangenis, Anna, Ghazaryan, Hrachuhi, Godycki-Cwirko, Maciek, Jensen, Siri, Lionis, Christos, van der Linde, Sanne R, Malania, Lile, Pauer, Jozsef, Tomacinschii, Angela, Vellinga, Akke, Zastavnyy, Ihor, Emmerich, Susanne, Zerda, Adam, Verheij, Theo J, Goossens, Herman, and Butler, Christopher C

Published
2022

9. COVID-19 i exposició prèvia a antibiòtics : una combinació perillosa

Author

Llor i Vilà, Carles, Giner-Soriano, Maria, Garcia-Sangenis, Ana, Bjerrum, Lars, Morros, Rosa, and Ouchi, Dan

Abstract

En un estudi de cohorts de tots els pacients diagnosticats de COVID-19 a Catalunya amb complicacions de la malaltia, un grup d'investigació ha estudiat la seva relació amb els antibiòtics. Tenint en compte la intensitat, la presa recent i antibiòtics d'alta prioritat han conclòs que el perill de malaltia greu o mort augmentava en un 12% amb la presa d'antibiòtics. Tot i així, hi ha variacions considerables entre grups, sent els que havien pres antibiòtic més recentment els més vulnerables. Això es deu a l'alteració de la microbiota, sobretot la intestinal, reduint-ne la diversitat i alterant així la immunitat del pacient. En un estudio de cohortes de todos los pacientes diagnosticados de COVID-19 en Cataluña con complicaciones de la enfermedad, un grupo de investigación ha estudiado su relación con los antibióticos. Teniendo en cuenta la intensidad, la toma reciente y antibióticos de alta prioridad han concluido que el peligro de contraer una enfermedad grave o la muerte aumentaba un 12% con la toma de antibióticos. Aun así, existen variaciones considerables entre grupos, siendo los que habían tomado antibióticos más recientemente los más vulnerables. Eso se debe a una alteración de la microbiota, sobre todo la intestinal, reduciendo su diversidad y alterando así la inmunidad del paciente. In a cohort study of all patients diagnosed with COVID-19 in Catalunya with disease's complications, a group of investigation has studied its relationship with the antibiotics. Considering the intensity, the recent take, and high priority antibiotics they conclude that the danger of contracting a serious illness or die augmented a 12% with an antibiotic's intake. However, considerable variations exist between groups, being those who had taken antibiotics recently the most vulnerable. This fact accounts to an alteration in the microbiota, especially intestinal, reducing its diversity and therefore altering the patient's immunity.

Published
2022

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