Oseltamivir for Influenza Postexposure Prophylaxis

Talbird, Sandra; Brogan, Anita; Winiarski, Aleksander P.

doi:10.1016/j.amepre.2009.08.012

Cited by 6 publications

(5 citation statements)

References 47 publications

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“…Within the study selection process, multiple studies had the same first author. For SI, one author conducted ten studies [ 32 – 42 ], two authors conducted three studies [ 49 – 51 , 67 – 69 ] and three authors conducted two studies [ 23 , 24 , 55 , 56 , 60 , 61 ], while for EBC, one author conducted three studies [ 93 – 95 ] and three authors conducted two studies [ 80 , 81 , 103 , 104 , 109 , 110 ].…”

Section: Resultsmentioning

confidence: 99%

“…The context in which ‘validation’ was used diverged widely. Three studies did not use validation in a model validation context [ 27 , 52 , 53 ]; two studies mentioned that the evidence level of some input data was low and not validated [ 47 , 57 ]; one study stated that picking a starting date for the simulation between two influenza seasons would be useful “to demonstrate model validity”, but did not specify how this was the case [ 48 ]; two studies used the word ‘validation’ in a context that might be linked to a validation technique, but did not provide information on which parts of the model were validated, by whom, or which techniques were used [ 44 , 64 ]; and three studies stated that a previously validated model was used, without stating whether the model would be valid for the new purpose [ 56 , 60 , 61 ]. Consulting the prior publications these studies were based on did not provide further clarification on validation efforts performed.…”

Section: Resultsmentioning

confidence: 99%

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Unremarked or Unperformed? Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

et al. 2016

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BackgroundTransparent reporting of validation efforts of health economic models give stakeholders better insight into the credibility of model outcomes. In this study we reviewed recently published studies on seasonal influenza and early breast cancer in order to gain insight into the reporting of model validation efforts in the overall health economic literature.MethodsA literature search was performed in Pubmed and Embase to retrieve health economic modelling studies published between 2008 and 2014. Reporting on model validation was evaluated by checking for the word validation, and by using AdViSHE (Assessment of the Validation Status of Health Economic decision models), a tool containing a structured list of relevant items for validation. Additionally, we contacted corresponding authors to ask whether more validation efforts were performed other than those reported in the manuscripts.ResultsA total of 53 studies on seasonal influenza and 41 studies on early breast cancer were included in our review. The word validation was used in 16 studies (30 %) on seasonal influenza and 23 studies (56 %) on early breast cancer; however, in a minority of studies, this referred to a model validation technique. Fifty-seven percent of seasonal influenza studies and 71 % of early breast cancer studies reported one or more validation techniques. Cross-validation of study outcomes was found most often. A limited number of studies reported on model validation efforts, although good examples were identified. Author comments indicated that more validation techniques were performed than those reported in the manuscripts.ConclusionsAlthough validation is deemed important by many researchers, this is not reflected in the reporting habits of health economic modelling studies. Systematic reporting of validation efforts would be desirable to further enhance decision makers’ confidence in health economic models and their outcomes.Electronic supplementary materialThe online version of this article (doi:10.1007/s40273-016-0410-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Unremarked or Unperformed? Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

et al. 2016

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“…United States analysis of post-exposure prophylaxis with oseltamivir in children up to 12 years was cost-effective in the perspectives of society and the payer, with 2008’s costs (Talbird et al, 2009). The model compared prophylaxis to no prophylaxis and predicted development of influenza, hospital admission, outpatient care, death, and survival (Talbird et al, 2009). The research was commissioned by Roche, and the last author was its employee.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Influenza A (H1N1) Chemoprophylaxis in Brazil

et al. 2019

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Background: Oseltamivir and zanamivir are recommended for treating and preventing influenza A (H1N1) worldwide. In Brazil, this official recommendation lacks an economic evaluation. Our objective was to assess the efficiency of influenza A chemoprophylaxis in the Brazilian context. Methods: We assessed the cost-effectiveness of oseltamivir and zanamivir for prophylaxis of influenza for high risk population, compared to no prophylaxis, in the perspective of Brazilian public health system. Quality-adjusted life years (QALY) and effectiveness data were based on literature review and costs in Brazilian real (BRL) were estimated from official sources and micro-costing of 2016’s H1N1 admissions at a university hospital. We used a decision-tree model considering prophylaxis and no prophylaxis and the probabilities of H1N1, ambulatory care, admission to hospital, intensive care, patient discharge, and death. Adherence and adverse events from prophylaxis were included. Incremental cost-effectiveness ratio was converted to 2016 United States dollar (USD). Uncertainty was assessed with univariated and probabilistic sensitivity analysis. Results: Adherence to prophylaxis was 0.70 [95% confidence interval (CI) 0.54; 0.83]; adverse events, 0.09 (95% CI 0.02; 0.18); relative risk of H1N1 infection in chemoprophylaxis, 0.43 (95% CI 0.33; 0.57); incidence of H1N1, 0.14 (95% CI 0.11; 0.16); ambulatory care, 0.67 (95% CI 0.58; 0.75); hospital admission, 0.43 (CI 95% 0.39; 0.42); hospital mortality, 0.14 (CI 95% 0.12; 0.15); intensive care unit admission, 0.23 (95% CI 0.20; 0.27); and intensive care mortality, 0.40 (95% CI 0.29; 0.52). QALY in H1N1 state was 0.50 (95% CI 0.46; 0.53); in H1N1 inpatients, 0.23 (95% CI 0.18; 0.28); healthy, 0.885 (95% CI 0.879; 0.891); death, 0. Adverse events estimated to affect QALY in –0.185 (95% CI –0.290; –0.050). Cost for chemoprophylaxis was BRL 39.42 [standard deviation (SD) 17.94]; ambulatory care, BRL 12.47 (SD 5.21); hospital admission, BRL 5,727.59 (SD 7,758.28); intensive care admission, BRL 19,217.25 (SD 7,917.33); and adverse events, BRL 292.05 (SD 724.95). Incremental cost-effectiveness ratio was BRL –4,080.63 (USD –1,263.74)/QALY and –982.39 (USD –304.24)/H1N1 prevented. Results were robust to sensitivity analysis. Conclusion: Chemoprophylaxis of influenza A (H1N1) is cost-saving in Brazilian health system context.

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“…If this number is used as a benchmark for a measles treatment course, the available budget would amount to 2.5 cents per dose, assuming a 20-day treatment cycle and twice daily dosing. However, an acceptable cost of $100.00 per treatment cycle seems more realistic for a small-molecule agent based on the precedence set by oseltamivir (Tamiflu) treatment of influenza virus infections (58). Importantly, cost-effectiveness simulations of oseltamivir for post-exposure prophylaxis in children in the United States returned effectiveness ratios similar to those of influenza vaccination (58).…”

Section: 4 Desirable Drug Profilementioning

confidence: 99%

“…However, an acceptable cost of $100.00 per treatment cycle seems more realistic for a small-molecule agent based on the precedence set by oseltamivir (Tamiflu) treatment of influenza virus infections (58). Importantly, cost-effectiveness simulations of oseltamivir for post-exposure prophylaxis in children in the United States returned effectiveness ratios similar to those of influenza vaccination (58). Even with a $100.00/treatment cycle budget cap, the feasibility of cost-effective production must be evaluated critically at an early stage of a measles therapeutic development campaign, since candidate classes inherently associated with high production and/or delivery costs such as larger peptidic antivirals or antisense inhibitors cannot seriously provide a viable treatment option.…”

Section: 4 Desirable Drug Profilementioning

confidence: 99%

Synergizing vaccinations with therapeutics for measles eradication

Plemper

Hammond

2013

Expert Opinion on Drug Discovery

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Introduction Measles virus is a major human pathogen responsible for approximately 150,000 measles deaths annually. The disease is vaccine preventable and eradication of the virus is considered feasible in principle. However, a herd immunity exceeding 95% is required to prevent sporadic viral outbreaks in a population. Declining disease prevalence combined with public anxieties about vaccination safety has increased vaccine refusal especially in the European region, which has resulted in measles resurgence in some areas. Areas covered Here, we discuss whether synergizing effective measles therapeutics with vaccination could contribute to solving an endgame conundrum of measles elimination by accelerating the eradication effort. Based on an anticipated use for protection of high-risk contacts of confirmed measles cases through post-exposure prophylaxis, we identify key elements of the desirable drug profile, review current disease management strategies and the state of experimental inhibitor candidates, evaluate the risk associated with viral escape from inhibition, and consider the potential of measles therapeutics for the management of persistent viral infection of the CNS. Assuming a post-measles world with waning measles immunity, we contemplate the possible impact of therapeutics on controlling the threat imposed by closely related zoonotic pathogens of the same genus as measles virus. Expert opinion Efficacious therapeutics given for post-exposure prophylaxis of high-risk social contacts of confirmed index cases may aid measles eradication by closing herd immunity gaps due to vaccine refusal or failure in populations with overall good vaccination coverage. The envisioned primarily prophylactic application of measles therapeutics to a predominantly pediatric and/or adolescent patient population dictates the drug profile; the article must be safe and efficacious, orally available, shelf-stable at ambient temperature, and amenable to cost-effective manufacture.

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Oseltamivir for Influenza Postexposure Prophylaxis

Cited by 6 publications

References 47 publications

Unremarked or Unperformed? Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

Unremarked or Unperformed? Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

Cost-Effectiveness Analysis of Influenza A (H1N1) Chemoprophylaxis in Brazil

Synergizing vaccinations with therapeutics for measles eradication

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