Economic Analysis of Influenza Vaccination and Antiviral Treatment for Healthy Working Adults

• Published in: Annals of internal medicine Vol. 137; no. 4; pp. 225 - 231
• Main Authors: Lee, Patrick Y., Matchar, David B., Clements, Dennis A., Huber, Joel, Hamilton, John D., Peterson, Eric D.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American College of Physicians 20.08.2002
• Subjects: Acetamides - adverse effects; Acetamides - economics; Acetamides - therapeutic use; Adolescent; Adult; Adults; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - adverse effects; Antiviral Agents - economics; Antiviral Agents - therapeutic use; Benefit cost analysis; Biological and medical sciences; Computer Simulation; Cost of Illness; Cost-Benefit Analysis; Decision Trees; Drug Costs; Guanidines; Humans; Influenza; Influenza Vaccines - economics; Influenza, Human - drug therapy; Influenza, Human - economics; Influenza, Human - prevention & control; Medical sciences; Middle Aged; Oseltamivir; Pharmacology. Drug treatments; Pyrans; Rimantadine - adverse effects; Rimantadine - economics; Rimantadine - therapeutic use; Sensitivity and Specificity; Sialic Acids - adverse effects; Sialic Acids - economics; Sialic Acids - therapeutic use; Vaccination - economics; Vaccines; Zanamivir; Human; Healthy subject; Vaccination; Orthomyxoviridae; Cost benefit analysis; Influenzavirus; Infection; Virus; Prevention; Immunoprophylaxis; Chemotherapy; Treatment; Health economy; Influenza; Viral disease; Adult; Antiviral; Worker; Public health
• ISSN: 0003-4819; 1539-3704; 1539-3704
• DOI: 10.7326/0003-4819-137-4-200208200-00005

Physicians have several treatment options for influenza, including vaccination and various antiviral therapies. However, the optimal influenza prevention and treatment strategy is unknown. To compare the relative health values of contemporary treatment strategies for influenza in a healthy sample of working adults. Cost-benefit analysis using a decision model. Previously published data. Healthy employed adults 18 to 50 years of age. A complete influenza season. Societal. Eight treatment options (yes or no) based on the possible combinations of vaccination and antiviral therapy (rimantadine, oseltamivir, or zanamivir or no treatment) should infection develop. Cost in U.S. dollars, including the value of symptom relief and medication side effects, which was assigned a monetary value through a conjoint analysis that used a "willingness-to-pay" approach. In the base-case analysis, all strategies for influenza vaccination had a higher net benefit than the nonvaccination strategies. Vaccination and use of rimantadine, the most cost-beneficial strategy, was $30.97 more cost-beneficial than nonvaccination and no use of antiviral medication. The health benefits of most antiviral treatments equaled or exceeded their costs for most scenarios. The choice of the most cost-beneficial antiviral strategy was sensitive to the prevalence of influenza B and to the comparative workdays gained by each antiviral therapy. Vaccination is cost-beneficial in most influenza seasons in healthy working adults. Although the benefits of antiviral therapy for persons with influenza infection appear to justify its cost, head-to-head trials of the various antiviral therapies are needed to determine the optimal treatment strategy.