Primary Physicians Research, Pittsburgh, Pennsylvania, USA.
Clin Drug Investig. 2004;24(7):395-407. doi: 10.2165/00044011-200424070-00003.
To evaluate the effect of treating children with influenza with oseltamivir on health outcomes and costs to healthcare payers.
Health outcome data from the oseltamivir paediatric clinical development programme plus data from the literature were used in an economic model developed to predict morbidity and mortality due to influenza and its specified complications. Published data on the cost of care in the UK were used to compare oseltamivir with usual care in children aged 1-12 and 1-5 years by estimating cost-effectiveness and cost-utility ratios.
Oseltamivir reduced median time to return to normal health and activity by almost 2 days (40% reduction, 67.1 vs 111.7 hours; p < 0.0001) versus placebo. In children aged 1-5 years, a 48% reduction (63.5 vs 121.3 hours; p = 0.0003) was observed. Oseltamivir-treated children who developed otitis media returned to normal health and activity 30% faster (99.6 vs 141.5 hours; p = 0.0517) than the placebo group. In the economic model, oseltamivir in the base-case analysis (assuming 60% diagnostic accuracy, full compliance, and 100% receive and start treatment within 48 hours, standard discounting according to the UK National Institute of Clinical Excellence guidelines) resulted in favourable cost-utility ratios in children aged both 1-12 and 1-5 years, with incremental cost-utility rates of £11 173/quality-adjusted life year (QALY) and oseltamivir being dominant compared with usual care, respectively (year of costing, 2002). Even in conservative scenarios, most cost-utility ratios remained <£30 000/QALY.
Oseltamivir is an effective treatment for children with influenza, allowing faster return to normal health and activity compared with usual care. From the healthcare payer perspective, oseltamivir is a potentially cost-effective strategy for otherwise healthy children.
评估奥司他韦治疗儿童流感对健康结果和医疗保健支付者成本的影响。
使用来自奥司他韦儿科临床开发计划的健康结果数据和文献中的数据，结合经济模型来预测流感及其特定并发症导致的发病率和死亡率。使用英国已发表的护理成本数据，通过估计成本效益和成本效用比，将奥司他韦与 1-12 岁和 1-5 岁儿童的常规护理进行比较。
奥司他韦与安慰剂相比，几乎将儿童恢复正常健康和活动的中位数时间缩短了 2 天（40%的减少，67.1 小时对 111.7 小时；p<0.0001）。在 1-5 岁的儿童中，观察到 48%的减少（63.5 小时对 121.3 小时；p=0.0003）。患有中耳炎的奥司他韦治疗儿童恢复正常健康和活动的速度快 30%（99.6 小时对 141.5 小时；p=0.0517）。在经济模型中，在基础案例分析中（假设诊断准确性为 60%，完全遵守，并且 100%的患者在 48 小时内接受并开始治疗，根据英国国家临床卓越研究所指南进行标准贴现），奥司他韦在 1-12 岁和 1-5 岁的儿童中都产生了有利的成本效用比，增量成本效用率分别为 11173 英镑/质量调整生命年（QALY）和奥司他韦与常规护理相比具有优势（成本计算年份为 2002 年）。即使在保守的情况下，大多数成本效用比仍低于 30000 英镑/QALY。
奥司他韦是治疗儿童流感的有效方法，与常规护理相比，能更快地恢复健康和活动。从医疗保健支付者的角度来看，奥司他韦是一种具有成本效益的策略，适用于健康状况良好的儿童。
