Authors' objectives: What is the cost-effectiveness of antiviral drugs administered to individuals who are not hospitalized for the prophylaxis and treatment of influenza A or B or zoonotic influenza?

Authors' results and conclusions: What Is the Issue? Influenza is a major public health concern, causing significant illness, death, economic challenges, and pandemic potential. This underscores the need for effective prevention (also known as prophylaxis), treatment, and pandemic preparedness strategies. Antiviral medications such as baloxavir marboxil, oseltamivir, peramivir, zanamivir are recommended for the treatment of influenza; however, their economic value remains unclear. What Did We Do? We conducted a rapid review to identify and summarize evidence on the cost-effectiveness of antivirals for preventing and treating influenza A, influenza B, and zoonotic influenza, as well as the cost-effectiveness of antiviral stockpiling. We searched electronic databases and key online sources for economic evaluation studies published in English from January 1, 2019, to December 13, 2024. Additionally, we examined the cost-effectiveness of stockpiling from studies published from January 1, 2020, to April 4, 2025. One researcher screened citations, selected studies, and narratively summarized the study findings. What Did We Find? We identified 9 economic evaluations: 8 examining the treatment of influenza and 1 examining both post-exposure prophylaxis and treatment. We did not identify any studies on the cost-effectiveness of antivirals for the prophylaxis or treatment of zoonotic influenza or any studies that evaluated the cost-effectiveness of stockpiling antiviral drugs. Economic studies suggest that certain antivirals may be cost-effective for treating influenza compared to standard of care, particularly in high-risk populations. However, it is unclear how cost-effective antivirals are for post-exposure prophylaxis, as there is limited evidence from just 1 study. What Does It Mean? Economic evaluations suggest that oseltamivir or baloxavir marboxil are cost-effective treatments for influenza, particularly in high-risk populations. Baloxavir marboxil may be a valuable alternative in cases of oseltamivir resistance to ensure optimal resource allocation and long-term sustainability of antiviral treatments. However, its higher cost requires careful consideration. The generalizability of existing economic evaluations may be limited due to variability in influenza strains, health care systems, and cost structures that differ from Canada.

Project Status: Completed

URL for project: https://www.cda-amc.ca/cost-effectiveness-antiviral-drugs-prevent-or-treat-influenza-influenza-b-or-zoonotic-influenza

Year Published: 2026

URL for published report: https://www.cda-amc.ca/cost-effectiveness-antiviral-drugs-prevent-or-treat-influenza-influenza-b-or-zoonotic-influenza

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Canada

Organisation Name: Canada’s Drug Agency (CDA-AMC)

Contact Address: 865 Carling Ave., Suite 600 Ottawa, ON Canada K1S 5S8

Contact Name: Shannon Nordstrom

Contact Email: shannon.nordstrom@cda-amc.ca

Copyright: 2025 Canadian Agency for Drugs and Technologies in Health