OBJECTIVES: In 2009, the H1N1 influenza epidemic in the United States caused over 19,000 deaths. This study aims to conduct an economic evaluation of the two most commonly recommended treatment choices for the H1N1 flu, oseltamivir and zanamivir. METHODS: A cost effectiveness analysis was performed by evaluating randomized clinical trials (RCTs) and other published literature for oseltamivir and zanamivir. Direct medical costs included drug costs, cost of hospitalization, cost associated with complications and adverse drug events. Effectiveness was assessed using efficacy data from RCTs. All costs were adjusted to 2011 USD using consumer price index. The primary outcome measures were the duration and severity of illness in infected patients. A decision tree analysis model was developed using TreeAge Pro 2009 from a US third party perspective. One way sensitivity analysis using total cost was conducted to evaluate the robustness of results. RESULTS: Efficacy of oseltamivir and zanamivir was found to be 69% and 81%, respectively. Total cost for treating H1N1 patient was higher for oseltamivir ($1878) compared to zanamivir ($1099). The expected cost of treatment per unit change was higher for osletamivir ($27.2) compared to zanamivir ($13.6). ICER was found to be $64.91 per unit change. Results of one way sensitivity analysis were robust with results of the decision tree model. CONCLUSIONS: This study provides some preliminary conclusion that zanamivir was more cost effective as compared to oseltamivir for treatment of H1N1 flu, from US third party perspective. Further research with prospective data may help providers make informed decisions, if such an epidemic happens again.
Kakad, S. N., & Sansgiry, S. S. (2012). PIN40 Oseltamivir and Zanamivir As a Treatment Choice for H1N1 Influenza: An Economic Evaluation. Value in Health, 15(4), A244. https://doi.org/10.1016/j.jval.2012.03.1316