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Economic Evaluation of Oseltamivir Phosphate for Postexposure Prophylaxis of Influenza in Long‐Term Care Facilities
Author(s) -
Risebrough Nancy A.,
Bowles Susan K.,
Simor Andrew E.,
McGeer Alison,
Oh Paul I.
Publication year - 2005
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2005.53162.x
Subject(s) - oseltamivir , medicine , amantadine , vaccination , long term care , intensive care medicine , adverse effect , dosing , outbreak , emergency medicine , virology , covid-19 , psychiatry , infectious disease (medical specialty) , disease
Objectives: To compare the cost‐effectiveness of oseltamivir postexposure prophylaxis during influenza A outbreaks with that of amantadine postexposure prophylaxis or no postexposure prophylaxis in long‐term care facilities (LTCFs). Design: Cost‐effectiveness analysis based on decision analytic model from a government‐payer perspective. Setting: A Canadian LTCF, with high staff vaccination, at the beginning of influenza season. Participants: Elderly, influenza‐vaccinated patients living in a Canadian LTCF. Measurements: Incremental costs (or savings) per influenza‐like illness case avoided compared with usual care. Results: From a government‐payer perspective, this analysis showed that oseltamivir was a dominant strategy because it was associated with the fewest influenza‐like illness cases, with cost savings of $1,249 per 100 patients in 2001 Canadian dollars compared with amantadine and $3,357 per 100 patients compared with no prophylaxis. Costs for amantadine dose calculation and hospitalization for adverse events contributed to amantadine being a more‐expensive prophylaxis strategy than oseltamivir. Both prophylaxis strategies were more cost‐effective than no prophylaxis. Conclusion: Despite high influenza vaccination rates, influenza outbreaks continue to emerge in LTCFs, necessitating cost‐effective measures to further limit the spread of influenza and related complications. Although amantadine has a lower acquisition cost than oseltamivir, it is associated with more adverse events, lower efficacy, and individualized dosing requirements, leading to higher overall costs and more influenza‐like illness cases than oseltamivir. Therefore the use of oseltamivir postexposure prophylaxis is more cost‐effective than the current standard of care with amantadine prophylaxis or no prophylaxis.