NEW YORK (Reuters Health) – Administration of the trivalent influenza vaccine to all healthy adults saves money over treatment of those who develop influenza-like illnesses with the oral neuraminidase inhibitor oseltamivir or supportive care alone, report investigators from Cornell University and the New School University.
In Clinical Infectious Diseases for December 1, Drs. Peter A. Muennig and Kamran Khan define influenza-like illness as a fever of at least 37.7 degrees Centigrade along with a cough or sore throat. Supportive care would include rest, hydration, symptom relief and medical care as needed. Oral oseltamivir treatment would require 75 mg b.i.d. for 5 days.
They developed a decision-analysis model that included all healthy individuals between the ages of 15 and 65 years who lived in the US in 1997. The model assumed that no deaths would occur, that 10% of patients with flu-like illnesses would visit a clinician, that 95% of these would be prescribed oseltamivir, and that the risk of hospitalization due to influenza would be reduced by 50% among those taking oseltamivir.
The incidence of flu-like illnesses was the major predictor of cost savings. At more than 24.2 cases per 100 persons, "which is well below rates quoted in the medical literature," the authors write, vaccination would save money compared to providing supportive care alone.
Oseltamivir would be a cost-saving intervention relative to supportive care only if a 5-day course of the drug costs less than $15, Drs. Muennig and Khan calculate. Even if oseltamivir were free, vaccination would save costs overall.
Clin Inf Dis 2001;33:1879-1885.