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Cost-effectiveness of antiviral stockpiling and near-patient testing for potential influenza pandemic.

Siddiqui MR, Edmunds WJ - Emerging Infect. Dis. (2008)

Bottom Line: A decision analytical model was developed to investigate the cost-effectiveness of stockpiling antiviral (AV) drugs for a potential influenza pandemic in the United Kingdom and the possible role of near-patient testing in conserving AV drug stocks.Under base-case assumptions (including a fixed stockpile that was smaller than the clinical attack rate), the treat-only option (treating all symptomatic patients with AV drugs) would be considered cost-effective ( pound1,900- pound13,700 per quality-adjusted life year [QALY] gained, depending on the fatality scenario), compared with no intervention (nonintervention but management of cases as they arise).Stockpiling sufficient AV drugs (but not near-patient tests) to treat all patients with clinical cases would be cost-effective, provided AV drugs are effective at preventing deaths from pandemic influenza.

View Article: PubMed Central - PubMed

Affiliation: Health Protection Agency, London, UK. ruby.siddiqui@hpa.org.uk

ABSTRACT
A decision analytical model was developed to investigate the cost-effectiveness of stockpiling antiviral (AV) drugs for a potential influenza pandemic in the United Kingdom and the possible role of near-patient testing in conserving AV drug stocks. Under base-case assumptions (including a fixed stockpile that was smaller than the clinical attack rate), the treat-only option (treating all symptomatic patients with AV drugs) would be considered cost-effective ( pound1,900- pound13,700 per quality-adjusted life year [QALY] gained, depending on the fatality scenario), compared with no intervention (nonintervention but management of cases as they arise). The test-treat option (testing all symptomatic patients but treating those with positive tests results only) would result in moderate gains in QALYs over the treat-only option but at relatively large additional costs. Stockpiling sufficient AV drugs (but not near-patient tests) to treat all patients with clinical cases would be cost-effective, provided AV drugs are effective at preventing deaths from pandemic influenza.

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Related in: MedlinePlus

Decision analytical model tree of treatment strategies for patients with an influenza-like illness (ILI) during an influenza pandemic. All branches culminate in the subtree (indicated with +). QALY, quality-adjusted life year; CAR, clinical attack rate.
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Figure 1: Decision analytical model tree of treatment strategies for patients with an influenza-like illness (ILI) during an influenza pandemic. All branches culminate in the subtree (indicated with +). QALY, quality-adjusted life year; CAR, clinical attack rate.

Mentions: A decision analytical model (Figure 1) was constructed to compare the costs and quality-adjusted life year (QALY) loss associated with 3 potential strategies for the management of patients with ILI in the United Kingdom: 1) do not treat with AV drugs and manage complications if they arise (no intervention), 2) treat all patients with AV drugs (treat only), or 3) test then treat those who test positive for influenza with AV drugs (test-treat). Precision Tree (Palisade Corporation, Ithaca, NY, USA) running in Microsoft (Redmond, WA, USA) Excel was used to construct the model and @Risk (Palisade Corporation) was used to perform the probabilistic sensitivity analysis.


Cost-effectiveness of antiviral stockpiling and near-patient testing for potential influenza pandemic.

Siddiqui MR, Edmunds WJ - Emerging Infect. Dis. (2008)

Decision analytical model tree of treatment strategies for patients with an influenza-like illness (ILI) during an influenza pandemic. All branches culminate in the subtree (indicated with +). QALY, quality-adjusted life year; CAR, clinical attack rate.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2600182&req=5

Figure 1: Decision analytical model tree of treatment strategies for patients with an influenza-like illness (ILI) during an influenza pandemic. All branches culminate in the subtree (indicated with +). QALY, quality-adjusted life year; CAR, clinical attack rate.
Mentions: A decision analytical model (Figure 1) was constructed to compare the costs and quality-adjusted life year (QALY) loss associated with 3 potential strategies for the management of patients with ILI in the United Kingdom: 1) do not treat with AV drugs and manage complications if they arise (no intervention), 2) treat all patients with AV drugs (treat only), or 3) test then treat those who test positive for influenza with AV drugs (test-treat). Precision Tree (Palisade Corporation, Ithaca, NY, USA) running in Microsoft (Redmond, WA, USA) Excel was used to construct the model and @Risk (Palisade Corporation) was used to perform the probabilistic sensitivity analysis.

Bottom Line: A decision analytical model was developed to investigate the cost-effectiveness of stockpiling antiviral (AV) drugs for a potential influenza pandemic in the United Kingdom and the possible role of near-patient testing in conserving AV drug stocks.Under base-case assumptions (including a fixed stockpile that was smaller than the clinical attack rate), the treat-only option (treating all symptomatic patients with AV drugs) would be considered cost-effective ( pound1,900- pound13,700 per quality-adjusted life year [QALY] gained, depending on the fatality scenario), compared with no intervention (nonintervention but management of cases as they arise).Stockpiling sufficient AV drugs (but not near-patient tests) to treat all patients with clinical cases would be cost-effective, provided AV drugs are effective at preventing deaths from pandemic influenza.

View Article: PubMed Central - PubMed

Affiliation: Health Protection Agency, London, UK. ruby.siddiqui@hpa.org.uk

ABSTRACT
A decision analytical model was developed to investigate the cost-effectiveness of stockpiling antiviral (AV) drugs for a potential influenza pandemic in the United Kingdom and the possible role of near-patient testing in conserving AV drug stocks. Under base-case assumptions (including a fixed stockpile that was smaller than the clinical attack rate), the treat-only option (treating all symptomatic patients with AV drugs) would be considered cost-effective ( pound1,900- pound13,700 per quality-adjusted life year [QALY] gained, depending on the fatality scenario), compared with no intervention (nonintervention but management of cases as they arise). The test-treat option (testing all symptomatic patients but treating those with positive tests results only) would result in moderate gains in QALYs over the treat-only option but at relatively large additional costs. Stockpiling sufficient AV drugs (but not near-patient tests) to treat all patients with clinical cases would be cost-effective, provided AV drugs are effective at preventing deaths from pandemic influenza.

Show MeSH
Related in: MedlinePlus