tetano
Editor, Senior Moderator
Infect Dis Ther
. 2024 Aug 16.
doi: 10.1007/s40121-024-01027-9. Online ahead of print. Cost-Effectiveness of Baloxavir Marboxil Versus Oseltamivir or no Treatment for the Management of Influenza in the United States
Svenn Alexander Kommandantvold[SUP] 1 [/SUP], Shih-Chen Chang[SUP] 2 [/SUP], Andy Surinach[SUP] 3 [/SUP], Vincent Yau[SUP] 2 [/SUP], Jennie H Best[SUP] 2 [/SUP], Hassan Zaraket[SUP] 4 [/SUP], Hao Zhou[SUP] 2 [/SUP], Jeff Frimpter[SUP] 5 [/SUP], Marie-Helene Blanchet Zumofen[SUP] 6 [/SUP]
Affiliations
Introduction: This study sought to evaluate the cost-effectiveness of baloxavir marboxil compared with oseltamivir or no antiviral treatment from a US payer perspective using data from a real-world US administrative claims study. Given baloxavir's ability to rapidly stop viral shedding, the potential health economic implications of a baloxavir-induced population-level reduction in viral transmission was also explored.
Methods: A decision tree cost-effectiveness model was developed for seasonal influenza (2018-2020) using a lifetime time horizon with 3.0% discounting for costs and quality-adjusted life-years (QALYs). Patients aged ≥ 12 years could receive baloxavir, oseltamivir or no antiviral treatment. Patient characteristics, complications, and costs were derived from the Merative™ MarketScan[SUP]®[/SUP] Research Databases including US commercial claims and Medicare and Medicaid Supplemental databases. A scenario analysis explored the impact of reduced viral transmission with baloxavir.
Results: In the base case analysis, baloxavir was cost-effective within a willingness-to-pay threshold of US$100,000/QALY compared with oseltamivir [incremental cost-effectiveness ratio (ICER), $6813/QALY gained] or no antiviral treatment (ICER, $669/QALY gained). The net monetary benefit (NMB) of baloxavir was $1180 and $6208 compared with oseltamivir and no treatment, respectively. The NMB of baloxavir increased linearly with reductions in viral transmission, where a 5% transmission reduction yielded an NMB of $2592 versus oseltamivir and $7621 versus no treatment. Baloxavir became dominant (more effective and less costly, with ICERs < 0) starting with a 12.0% reduction in viral transmission versus oseltamivir and 6.0% versus no antiviral treatment.
Conclusion: Baloxavir was cost-effective compared with oseltamivir or no antiviral treatment. The potential of baloxavir to reduce viral transmission offers a substantial economic benefit from a US payer perspective.
Keywords: Antiviral treatment; Baloxavir; Commercial payer; Cost-effectiveness; Influenza; Oseltamivir; Pandemic; Real-world data; United States; Viral transmission.
. 2024 Aug 16.
doi: 10.1007/s40121-024-01027-9. Online ahead of print. Cost-Effectiveness of Baloxavir Marboxil Versus Oseltamivir or no Treatment for the Management of Influenza in the United States
Svenn Alexander Kommandantvold[SUP] 1 [/SUP], Shih-Chen Chang[SUP] 2 [/SUP], Andy Surinach[SUP] 3 [/SUP], Vincent Yau[SUP] 2 [/SUP], Jennie H Best[SUP] 2 [/SUP], Hassan Zaraket[SUP] 4 [/SUP], Hao Zhou[SUP] 2 [/SUP], Jeff Frimpter[SUP] 5 [/SUP], Marie-Helene Blanchet Zumofen[SUP] 6 [/SUP]
Affiliations
- PMID: 39150658
- DOI: 10.1007/s40121-024-01027-9
Introduction: This study sought to evaluate the cost-effectiveness of baloxavir marboxil compared with oseltamivir or no antiviral treatment from a US payer perspective using data from a real-world US administrative claims study. Given baloxavir's ability to rapidly stop viral shedding, the potential health economic implications of a baloxavir-induced population-level reduction in viral transmission was also explored.
Methods: A decision tree cost-effectiveness model was developed for seasonal influenza (2018-2020) using a lifetime time horizon with 3.0% discounting for costs and quality-adjusted life-years (QALYs). Patients aged ≥ 12 years could receive baloxavir, oseltamivir or no antiviral treatment. Patient characteristics, complications, and costs were derived from the Merative™ MarketScan[SUP]®[/SUP] Research Databases including US commercial claims and Medicare and Medicaid Supplemental databases. A scenario analysis explored the impact of reduced viral transmission with baloxavir.
Results: In the base case analysis, baloxavir was cost-effective within a willingness-to-pay threshold of US$100,000/QALY compared with oseltamivir [incremental cost-effectiveness ratio (ICER), $6813/QALY gained] or no antiviral treatment (ICER, $669/QALY gained). The net monetary benefit (NMB) of baloxavir was $1180 and $6208 compared with oseltamivir and no treatment, respectively. The NMB of baloxavir increased linearly with reductions in viral transmission, where a 5% transmission reduction yielded an NMB of $2592 versus oseltamivir and $7621 versus no treatment. Baloxavir became dominant (more effective and less costly, with ICERs < 0) starting with a 12.0% reduction in viral transmission versus oseltamivir and 6.0% versus no antiviral treatment.
Conclusion: Baloxavir was cost-effective compared with oseltamivir or no antiviral treatment. The potential of baloxavir to reduce viral transmission offers a substantial economic benefit from a US payer perspective.
Keywords: Antiviral treatment; Baloxavir; Commercial payer; Cost-effectiveness; Influenza; Oseltamivir; Pandemic; Real-world data; United States; Viral transmission.