tetano
Editor, Senior Moderator
J Infect Chemother
. 2020 Nov 23;S1341-321X(20)30377-9.
doi: 10.1016/j.jiac.2020.10.018. Online ahead of print.
Cost-effectiveness of baloxavir marboxil compared to laninamivir for the treatment of influenza in Japan
Aleksandra Skrzeczek[SUP] 1 [/SUP], Hidetoshi Ikeoka[SUP] 2 [/SUP], Nobuo Hirotsu[SUP] 3 [/SUP], Amir Ansaripour[SUP] 4 [/SUP], Samuel Aball?a[SUP] 5 [/SUP], Yoshie Onishi[SUP] 6 [/SUP], Mark Hill[SUP] 7 [/SUP], Ataru Igarashi[SUP] 8 [/SUP]
Affiliations
Abstract
Background: Baloxavir marboxil (baloxavir) is a new oral antiviral for influenza types A and B.
Objectives: To determine the cost-effectiveness of baloxavir versus laninamivir in otherwise healthy (OwH) adults in Japan.
Methods: A decision tree was utilized to describe the course of influenza and predict associated costs and quality-adjusted life-years (QALYs) over one year by antiviral. Costs were valued from the public healthcare payer perspective, including influenza test, antiviral acquisition, other medications, physician visits, other outpatient costs associated with influenza or drug-related adverse events (DRAEs), and hospitalizations. Resource utilization and unit costs were obtained from the analysis of the JammNet claims database. Health state utilities were obtained from a clinical trial of baloxavir and previous models, and were driven by influenza symptoms, DRAEs, and complications caused by influenza. Sensitivity analyses were also performed.
Results: The total payer expenditure per patient for baloxavir versus laninamivir was ?9383 versus ?9132. The additional acquisition costs of baloxavir were partly offset by the DRAE costs avoided. Baloxavir showed a small gain in QALYs versus laninamivir and the incremental cost per QALY gained (?2,231,260) was lower than the considered willingness-to-pay threshold (?5,000,000/QALY). Key model drivers were the probability of DRAEs and the duration of symptoms. The probability of baloxavir being cost-effective was 64%.
Conclusion: This cost-effectiveness study on baloxavir suggests that it would be cost-effective compared to laninamivir in OwH adults in Japan. Further studies are needed in different settings such as high-risk population and with different comparators.
Keywords: Baloxavir marboxil; Cost-effectiveness analysis; Influenza; Japan; Laninamivir; Otherwise healthy adults.
. 2020 Nov 23;S1341-321X(20)30377-9.
doi: 10.1016/j.jiac.2020.10.018. Online ahead of print.
Cost-effectiveness of baloxavir marboxil compared to laninamivir for the treatment of influenza in Japan
Aleksandra Skrzeczek[SUP] 1 [/SUP], Hidetoshi Ikeoka[SUP] 2 [/SUP], Nobuo Hirotsu[SUP] 3 [/SUP], Amir Ansaripour[SUP] 4 [/SUP], Samuel Aball?a[SUP] 5 [/SUP], Yoshie Onishi[SUP] 6 [/SUP], Mark Hill[SUP] 7 [/SUP], Ataru Igarashi[SUP] 8 [/SUP]
Affiliations
- PMID: 33243614
- DOI: 10.1016/j.jiac.2020.10.018
Abstract
Background: Baloxavir marboxil (baloxavir) is a new oral antiviral for influenza types A and B.
Objectives: To determine the cost-effectiveness of baloxavir versus laninamivir in otherwise healthy (OwH) adults in Japan.
Methods: A decision tree was utilized to describe the course of influenza and predict associated costs and quality-adjusted life-years (QALYs) over one year by antiviral. Costs were valued from the public healthcare payer perspective, including influenza test, antiviral acquisition, other medications, physician visits, other outpatient costs associated with influenza or drug-related adverse events (DRAEs), and hospitalizations. Resource utilization and unit costs were obtained from the analysis of the JammNet claims database. Health state utilities were obtained from a clinical trial of baloxavir and previous models, and were driven by influenza symptoms, DRAEs, and complications caused by influenza. Sensitivity analyses were also performed.
Results: The total payer expenditure per patient for baloxavir versus laninamivir was ?9383 versus ?9132. The additional acquisition costs of baloxavir were partly offset by the DRAE costs avoided. Baloxavir showed a small gain in QALYs versus laninamivir and the incremental cost per QALY gained (?2,231,260) was lower than the considered willingness-to-pay threshold (?5,000,000/QALY). Key model drivers were the probability of DRAEs and the duration of symptoms. The probability of baloxavir being cost-effective was 64%.
Conclusion: This cost-effectiveness study on baloxavir suggests that it would be cost-effective compared to laninamivir in OwH adults in Japan. Further studies are needed in different settings such as high-risk population and with different comparators.
Keywords: Baloxavir marboxil; Cost-effectiveness analysis; Influenza; Japan; Laninamivir; Otherwise healthy adults.