[Source: PLoS One, full page: (LINK). Abstract, edited.]
Open Access / Peer-reviewed / Research Article
Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis
Kunling Shen, Tengbin Xiong , Seng Chuen Tan, Jiuhong Wu
PLOS / Published: April 15, 2016 / http://dx.doi.org/10.1371/journal.pone.0153664
Influenza is a common viral respiratory infection that causes epidemics and pandemics in the human population. Oseltamivir is a neuraminidase inhibitor—a new class of antiviral therapy for influenza. Although its efficacy and safety have been established, there is uncertainty regarding whether influenza-like illness (ILI) in children is best managed by oseltamivir at the onset of illness, and its cost-effectiveness in children has not been studied in China.
To evaluate the cost-effectiveness of post rapid influenza diagnostic test (RIDT) treatment with oseltamivir and empiric treatment with oseltamivir comparing with no antiviral therapy against influenza for children with ILI.
We developed a decision-analytic model based on previously published evidence to simulate and evaluate 1-year potential clinical and economic outcomes associated with three managing strategies for children presenting with symptoms of influenza. Model inputs were derived from literature and expert opinion of clinical practice and research in China. Outcome measures included costs and quality-adjusted life year (QALY). All the interventions were compared with incremental cost-effectiveness ratios (ICER).
In base case analysis, empiric treatment with oseltamivir consistently produced the greatest gains in QALY. When compared with no antiviral therapy, the empiric treatment with oseltamivir strategy is very cost effective with an ICER of RMB 4,438. When compared with the post RIDT treatment with oseltamivir, the empiric treatment with oseltamivir strategy is dominant. Probabilistic sensitivity analysis projected that there is a 100% probability that empiric oseltamivir treatment would be considered as a very cost-effective strategy compared to the no antiviral therapy, according to the WHO recommendations for cost-effectiveness thresholds. The same was concluded with 99% probability for empiric oseltamivir treatment being a very cost-effective strategy compared to the post RIDT treatment with oseltamivir.
In the Chinese setting of current health system, our modelling based simulation analysis suggests that empiric treatment with oseltamivir to be a cost-saving and very cost-effective strategy in managing children with ILI.
Citation: Shen K, Xiong T, Tan SC, Wu J (2016) Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis. PLoS ONE 11(4): e0153664. doi:10.1371/journal.pone.0153664
Editor: Soren Gantt, University of British Columbia, CANADA
Received: December 1, 2015; Accepted: April 2, 2016; Published: April 15, 2016
Copyright: © 2016 Shen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: This project was sponsored by HEC Pharm, a subsidiary of HEC Group. The funder provided support in the form of salaries for authors Tengbin Xiong and Seng Chuen Tan, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.
Competing interests: Tengbin Xiong and Seng Chuen Tan are current employees of IMS Health, which received funds from HEC Pharm for this study. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials. No patents have been applied for relating to the content of the manuscript. None of the authors has any other financial or nonfinancial competing interests.
Keywords: Research; Abstracts; Seasonal Influenza; Antivirals; Oseltamivir; China.