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

被引:0
作者
Li, Xiao [1 ]
Bilcke, Joke [1 ]
van der Velden, Alike W. [2 ]
Bruyndonckx, Robin [3 ,4 ]
Coenen, Samuel [4 ,5 ]
Bongard, Emily [6 ]
de Paor, Muirrean [7 ]
Chlabicz, Slawomir [8 ]
Godycki-Cwirko, Maciek [9 ]
Francis, Nick [10 ]
Aabenhus, Rune [11 ]
Bucher, Heiner C. [12 ]
Colliers, Annelies [5 ]
De Sutter, An [13 ]
Garcia-Sangenis, Ana [14 ]
Glinz, Dominik [15 ]
Harbin, Nicolay J. [16 ]
Kosiek, Katarzyna [17 ]
Lindbaek, Morten [18 ]
Lionis, Christos [19 ]
Llor, Carl [14 ,20 ]
Miko-Pauer, Reka [21 ]
Jurgute, Ruta Radzeviciene [22 ]
Seifert, Bohumil [23 ]
Sundvall, Par-Daniel [24 ,25 ]
Lundgren, Pia Touboul [26 ]
Tsakountakis, Nikolaos [27 ]
Verheij, Theo J. [2 ]
Goossens, Herman [5 ]
Butler, Christopher C. [6 ]
Beutels, Philippe [1 ]
机构
[1] Univ Antwerp, Ctr Hlth Econ Res & Modelling Infect Dis CHERMID, Vaccine & Infect Dis Inst VAXINFECTIO, Campus Drie Eiken,Room DS-221,Univ Pl 1, B-2610 Antwerp, Belgium
[2] Univ Med Ctr, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
[3] Hasselt Univ, Data Sci Inst DSI, Interuniv Inst Biostat & Stat Bioinformat I BIOST, Hasselt, Belgium
[4] Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, Lab Med Microbiol, Antwerp, Belgium
[5] Univ Antwerp, Dept Family Med & Populat Hlth FAMPOP, Antwerp, Belgium
[6] Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Oxford, England
[7] RCSI Dept Gen Practice, 123 St Stephens Green, Dublin 2, Ireland
[8] Med Univ Bialystok, Dept Family Med, Bialystok, Poland
[9] Med Univ Lodz, Ctr Family & Community Med, Lodz, Poland
[10] Univ Southampton, Fac Med, Sch Primary Care Populat Sci & Med Educ, Southampton, Hants, England
[11] Univ Copenhagen, Dept Publ Hlth, Sect & Res Unit Gen Practice, Copenhagen, Denmark
[12] Univ Hosp Basel, Div Infect Dis & Hosp Hyg, Basel Inst Clin Epidemiol & Biostat, Basel, Switzerland
[13] Univ Ghent, Ctr Family Med, Dept Publ Hlth & Primary Care, Ghent, Belgium
[14] Univ Inst Primary Care Res Jordi Gol, Via Roma Hlth Ctr, Barcelona, Spain
[15] Univ Hosp Basel, Basel Inst Clin Epidemiol & Biostat, Dept Clin Res, Basel, Switzerland
[16] Univ Oslo, Antibiot Ctr Primary Care, Inst Hlth & Soc, Dept Gen Practice, Oslo, Norway
[17] Family Doctors Clin, Lodz, Poland
[18] Univ Oslo, Antibiot Ctr Primary Care, Dept Gen Practice, Oslo, Norway
[19] Univ Crete, Sch Med, Gen Practice & Primary Hlth Care, Iraklion, Greece
[20] Univ Copenhagen, Dept Publ Hlth, Res Unit Gen Practice, Copenhagen, Denmark
[21] DRC Drug Res Ctr LLC, Balatonfared, Hungary
[22] FDC Mano Seimos Gydytojas, Klaipeda, Lithuania
[23] Charles Univ Prague, Fac Med 1, Inst Gen Practice, Prague, Czech Republic
[24] Univ Gothenburg, Gen Practice Family Med, Sch Publ Hlth & Community Med, Inst Med,Sahlgrenska Acad, Gothenburg, Sweden
[25] Reg Vastra Gotaland, Primary Hlth Care, Res Educ Dev & Innovat, Sandared, Sweden
[26] Hop Archet, Dept Sante Publ, Nice, France
[27] Kastelli HC, Malia Surg, Iraklion, Greece
关键词
Tamiflu; Cost-utility analysis; Europe; Multi-country; QALY; ILI; Direct cost; Indirect cost; Productivity losses; ADULTS; METAANALYSIS;
D O I
10.1007/s10198-022-01521-2
中图分类号
F [经济];
学科分类号
02 ;
摘要
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.
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页码:909 / 922
页数:14
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