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Curr Med Res Opin . Cost-effectiveness of Baloxavir Marboxil compared with Laninamivir for the treatment of influenza in patients at high risk for

tetano

Editor, Senior Moderator
Curr Med Res Opin


. 2021 Apr 15;1.
doi: 10.1080/03007995.2021.1914942. Online ahead of print.
Cost-effectiveness of Baloxavir Marboxil compared with Laninamivir for the treatment of influenza in patients at high risk for complications in Japan


Mariia Dronova[SUP] 1 [/SUP], Hidetoshi Ikeoka[SUP] 2 [/SUP], Naoya Itsumura[SUP] 2 [/SUP], Nobuo Hirotsu[SUP] 3 [/SUP], Amir Ansaripour[SUP] 4 [/SUP], Samuel Aball?a[SUP] 4 [/SUP], Yoshie Onishi[SUP] 5 [/SUP], Mark Hill[SUP] 6 [/SUP], Ataru Igarashi[SUP] 7 [/SUP]



Affiliations

Abstract

Objective: Baloxavir marboxil (baloxavir) is a single-dose antiviral which was previously found to be a cost-effective alternative to laninamivir in otherwise healthy adults in Japan. This study aimed at investigating the cost-effectiveness of baloxavir versus laninamivir in patients with influenza at high risk for complications.Methods: A decision tree was utilized to estimate costs and health gains associated with the use of antivirals. The lifetime horizon was applied to capture the long-term impact of influenza complications, other events with associated costs and health outcomes were accounted for one influenza season. The study population was stratified into three categories: adolescents and non-elderly adults with high-risk conditions (HRC), elderly without other HRC, and elderly with other HRC. The cost-effectiveness was assessed from a public health care payer's perspective. The duration of influenza symptoms, probabilities of complications and probabilities of adverse events were obtained from a clinical trial and network meta-analysis. The costs of influenza and adverse events management were derived from the JammNet claims database. Utility values were informed by clinical trial data and literature. Sensitivity analyses were also performed.Results: The baloxavir strategy was associated with higher costs (+?144) and higher quality-adjusted life-years (QALYs) in adults with HRC, elderly without HRC and elderly with HRC (+0.00078, +0.00183 and +0.00350 respectively). The overall incremental cost/QALY for baloxavir versus laninamivir was ?68,855, which was below the willingness-to-pay threshold of ?5 million/QALY gained. Key drivers of the model results were the probability of pneumonia and bronchitis. The probability of baloxavir being cost-effective was 72%.Conclusions: This study suggests that influenza treatment with baloxavir is cost-effective compared with laninamivir in the adult high-risk population in Japan.

Keywords: Baloxavir marboxil; Laninamivir; antiviral; cost-effectiveness analysis; high risk for complications; influenza.
 
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