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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

Probabilistic sensitivity analysis of the incremental cost-effectiveness of the treat-only over the no-intervention strategy and the test-treat strategy over the treat-only strategy for the A) 1918 and B) 1957/69 death scenarios (1,000 iterations). Cost-effective strategies lie to the right of the cost-effectiveness threshold (£30,000 per quality-adjusted life year [QALY] gained).
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Figure 4: Probabilistic sensitivity analysis of the incremental cost-effectiveness of the treat-only over the no-intervention strategy and the test-treat strategy over the treat-only strategy for the A) 1918 and B) 1957/69 death scenarios (1,000 iterations). Cost-effective strategies lie to the right of the cost-effectiveness threshold (£30,000 per quality-adjusted life year [QALY] gained).

Mentions: Model parameters were varied (Appendix Table) in a probabilistic sensitivity analysis, which suggests that for fixed AV drug and test stockpiles, the probability is high that the treat-only option would be cost-effective, irrespective of the fatality scenario (Figure 4). The test-treat option would result in small QALY gains (and often losses) but at substantial additional costs. The probability of this strategy being cost-effective is low compared with the treat-only option, particularly for the 1957/69 fatality scenario.


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

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

Probabilistic sensitivity analysis of the incremental cost-effectiveness of the treat-only over the no-intervention strategy and the test-treat strategy over the treat-only strategy for the A) 1918 and B) 1957/69 death scenarios (1,000 iterations). Cost-effective strategies lie to the right of the cost-effectiveness threshold (£30,000 per quality-adjusted life year [QALY] gained).
© Copyright Policy
Related In: Results  -  Collection

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

Figure 4: Probabilistic sensitivity analysis of the incremental cost-effectiveness of the treat-only over the no-intervention strategy and the test-treat strategy over the treat-only strategy for the A) 1918 and B) 1957/69 death scenarios (1,000 iterations). Cost-effective strategies lie to the right of the cost-effectiveness threshold (£30,000 per quality-adjusted life year [QALY] gained).
Mentions: Model parameters were varied (Appendix Table) in a probabilistic sensitivity analysis, which suggests that for fixed AV drug and test stockpiles, the probability is high that the treat-only option would be cost-effective, irrespective of the fatality scenario (Figure 4). The test-treat option would result in small QALY gains (and often losses) but at substantial additional costs. The probability of this strategy being cost-effective is low compared with the treat-only option, particularly for the 1957/69 fatality scenario.

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