Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness : economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries
© 2022. The Author(s)..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
The European journal of health economics : HEPAC : health economics in prevention and care - 24(2023), 6 vom: 21. Aug., Seite 909-922 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
20O93L6F9H |
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| Anmerkungen: |
Date Completed 26.06.2023 Date Revised 01.07.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10198-022-01521-2 |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Li, Xiao |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cost-effectiveness of adding oseltamivir to primary care for influenza-like-illness |b economic evaluation alongside the randomised controlled ALIC4E trial in 15 European countries |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 26.06.2023 | ||
| 500 | |a Date Revised 01.07.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cost-utility analysis | |
| 650 | 4 | |a Direct cost | |
| 650 | 4 | |a Europe | |
| 650 | 4 | |a ILI | |
| 650 | 4 | |a Indirect cost | |
| 650 | 4 | |a Multi-country | |
| 650 | 4 | |a Productivity losses | |
| 650 | 4 | |a QALY | |
| 650 | 4 | |a Tamiflu | |
| 650 | 7 | |a Oseltamivir |2 NLM | |
| 650 | 7 | |a 20O93L6F9H |2 NLM | |
| 700 | 1 | |a Bilcke, Joke |e verfasserin |4 aut | |
| 700 | 1 | |a van der Velden, Alike W |e verfasserin |4 aut | |
| 700 | 1 | |a Bruyndonckx, Robin |e verfasserin |4 aut | |
| 700 | 1 | |a Coenen, Samuel |e verfasserin |4 aut | |
| 700 | 1 | |a Bongard, Emily |e verfasserin |4 aut | |
| 700 | 1 | |a de Paor, Muirrean |e verfasserin |4 aut | |
| 700 | 1 | |a Chlabicz, Slawomir |e verfasserin |4 aut | |
| 700 | 1 | |a Godycki-Cwirko, Maciek |e verfasserin |4 aut | |
| 700 | 1 | |a Francis, Nick |e verfasserin |4 aut | |
| 700 | 1 | |a Aabenhus, Rune |e verfasserin |4 aut | |
| 700 | 1 | |a Bucher, Heiner C |e verfasserin |4 aut | |
| 700 | 1 | |a Colliers, Annelies |e verfasserin |4 aut | |
| 700 | 1 | |a De Sutter, An |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Sangenis, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Glinz, Dominik |e verfasserin |4 aut | |
| 700 | 1 | |a Harbin, Nicolay J |e verfasserin |4 aut | |
| 700 | 1 | |a Kosiek, Katarzyna |e verfasserin |4 aut | |
| 700 | 1 | |a Lindbæk, Morten |e verfasserin |4 aut | |
| 700 | 1 | |a Lionis, Christos |e verfasserin |4 aut | |
| 700 | 1 | |a Llor, Carl |e verfasserin |4 aut | |
| 700 | 1 | |a Mikó-Pauer, Réka |e verfasserin |4 aut | |
| 700 | 1 | |a Radzeviciene Jurgute, Ruta |e verfasserin |4 aut | |
| 700 | 1 | |a Seifert, Bohumil |e verfasserin |4 aut | |
| 700 | 1 | |a Sundvall, Pär-Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Touboul Lundgren, Pia |e verfasserin |4 aut | |
| 700 | 1 | |a Tsakountakis, Nikolaos |e verfasserin |4 aut | |
| 700 | 1 | |a Verheij, Theo J |e verfasserin |4 aut | |
| 700 | 1 | |a Goossens, Herman |e verfasserin |4 aut | |
| 700 | 1 | |a Butler, Christopher C |e verfasserin |4 aut | |
| 700 | 1 | |a Beutels, Philippe |e verfasserin |4 aut | |
| 700 | 0 | |a ALIC4Etrial investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Bongard, Emily |e investigator |4 oth | |
| 700 | 1 | |a de Paor, Muirrean |e investigator |4 oth | |
| 700 | 1 | |a Chlabicz, Slawomir |e investigator |4 oth | |
| 700 | 1 | |a Godycki-Cwirko, Maciek |e investigator |4 oth | |
| 700 | 1 | |a Francis, Nick |e investigator |4 oth | |
| 700 | 1 | |a Aabenhus, Rune |e investigator |4 oth | |
| 700 | 1 | |a Bucher, Heiner C |e investigator |4 oth | |
| 700 | 1 | |a Colliers, Annelies |e investigator |4 oth | |
| 700 | 1 | |a De Sutter, An |e investigator |4 oth | |
| 700 | 1 | |a Garcia-Sangenis, Ana |e investigator |4 oth | |
| 700 | 1 | |a Glinz, Dominik |e investigator |4 oth | |
| 700 | 1 | |a Harbin, Nicolay J |e investigator |4 oth | |
| 700 | 1 | |a Kosiek, Katarzyna |e investigator |4 oth | |
| 700 | 1 | |a Lindbæk, Morten |e investigator |4 oth | |
| 700 | 1 | |a Lionis, Christos |e investigator |4 oth | |
| 700 | 1 | |a Llor, Carl |e investigator |4 oth | |
| 700 | 1 | |a Mikó-Pauer, Réka |e investigator |4 oth | |
| 700 | 1 | |a Radzeviciene Jurgute, Ruta |e investigator |4 oth | |
| 700 | 1 | |a Seifert, Bohumil |e investigator |4 oth | |
| 700 | 1 | |a Sundvall, Pär-Daniel |e investigator |4 oth | |
| 700 | 1 | |a Touboul Lundgren, Pia |e investigator |4 oth | |
| 700 | 1 | |a Tsakountakis, Nikolaos |e investigator |4 oth | |
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