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Antiviral treatment for outpatient use during an influenza pandemic: a decision tree model of outcomes averted and cost-effectiveness

Myles, Puja R; Venkatesan, Sudhir; Carias, Cristina; Biggerstaff, Matthew; Campbell, Angela P; Nguyen-Van-Tam, Jonathan S; Kahn, Emily; Myles, Puja R.; Meltzer, Martin I

Authors

Puja R Myles

Sudhir Venkatesan sudhir.venkatesan@nottingham.ac.uk

Cristina Carias

Matthew Biggerstaff

Angela P Campbell

Emily Kahn

Puja R. Myles

Martin I Meltzer



Abstract

Background: Many countries have acquired antiviral stockpiles for pandemic influenza mitigation and a significant part of the stockpile may be focussed towards community-based treatment.

Methods: We developed a spreadsheet-based, decision tree model to assess outcomes averted and cost-effectiveness of antiviral treatment for outpatient use from the perspective of the healthcare payer in the UK. We defined five pandemic scenarios– one based on the 2009 A(H1N1) pandemic and four hypothetical scenarios varying in measures of transmissibility and severity.

Results: Community-based antiviral treatment was estimated to avert 14% to 23% of hospitalizations in an overall population of 62.28 million. Higher proportions of averted outcomes were seen in patients with high-risk conditions, when compared to non-high-risk patients. We found that antiviral treatment was cost-saving across pandemic scenarios for high-risk population groups, and cost-saving for the overall population in higher severity influenza pandemics. Antiviral effectiveness had the greatest influence on both the number of hospitalizations averted and on cost-effectiveness.

Conclusions: This analysis shows that across pandemic scenarios, antiviral treatment can be cost-saving for population groups at high risk of influenza-related complications.

Journal Article Type Article
Publication Date 2019-06
Journal Journal of Public Health
Print ISSN 1741-3842
Electronic ISSN 1741-3850
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 41
Issue 2
Pages 379–390
APA6 Citation Myles, P. R., Venkatesan, S., Carias, C., Biggerstaff, M., Campbell, A. P., Nguyen-Van-Tam, J. S., …Meltzer, M. I. (2019). Antiviral treatment for outpatient use during an influenza pandemic: a decision tree model of outcomes averted and cost-effectiveness. Journal of Public Health, 41(2), 379–390. doi:10.1093/pubmed/fdy108
DOI https://doi.org/10.1093/pubmed/fdy108
Publisher URL https://academic.oup.com/jpubhealth/article/41/2/379/5046089
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
Additional Information This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Public Health following peer review. The version of record Sudhir Venkatesan, Cristina Carias, Matthew Biggerstaff, Angela P Campbell, Jonathan S Nguyen-Van-Tam, Emily Kahn, Puja R Myles, Martin I Meltzer; Antiviral treatment for outpatient use during an influenza pandemic: a decision tree model of outcomes averted and cost-effectiveness, Journal of Public Health, fdy108 is available online at: https://doi.org/10.1093/pubmed/fdy108.

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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