Authors' objectives:

This study aimed to establish the clinical and cost-effectiveness of amantadine, oseltamivir and zanamivir for the treatment and prevention of influenza. The preventative strategies considered were amantadine, oseltamivir, zanamivir and vaccine, compared with no intervention. Vaccine was considered both on its own and in combination with amantadine, oseltamivir and zanamivir. The treatment strategies addressed were amantadine, oseltamivir and zanamivir compared with standard care. Four patient groups were considered: (i) children (aged <=12 years); (ii) healthy adults (aged 12-65 years); (iii) high-risk (aged >=65 years and/or with concomitant disease); and (iv) elderly residential population.

Authors' results and conclusions: Oseltamivir: - Treatment Oseltamivir 75 mg twice daily for 5 days was found to reduce the median duration of symptoms in the influenza positive group by: - 1.38 days (95% CI 0.80 to 1.96) for the otherwise healthy adult population - 0.50 days (95% CI 0.96 to 1.88) for the high-risk population - 1.5 days (95% CI 0.8 to 2.2) for the children population. - Prevention Oseltamivir 75 mg once daily for 6 weeks was found to provide a relative risk reduction of developing influenza by between approximately 75 and 90% depending on the strategy adopted and the population under consideration. Zanamivir: - Treatment Inhaled zanamivir 10 mg twice daily for 5 days was found to reduce the median duration of symptoms in the influenza positive group by: - 1.26 days (95% CI 0.59 to 1.93) for the otherwise healthy adult population - 1.99 days (95% CI 0.90 to 3.08) for the high-risk population - 1.3 days (95% CI 0.3 to 2.0) for the children population (high-risk and otherwise healthy combined). - Prevention Inhaled zanamivir 10 mg once daily for 6 weeks was found to provide a relative risk reduction of developing influenza by between approximately 70 and 90% depending on the strategy adopted and the population under consideration.

Authors' recommendations: The cost-effectiveness varies markedly between the intervention strategies and target populations. The effectiveness literature that was used to inform the economic decision model spans many decades and hence great caution should be exercised when interpreting the results of indirect intervention comparisons from the model. Further randomised trials making direct comparisons would be valuable to verify the findings from the model.

Authors' methods: Systematic review, Economic evaluation

Project Status: Completed

URL for project: http://www.hta.ac.uk/1299

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

Copyright: 2009 Queen's Printer and Controller of HMSO