Cost Analysis of the Use of Rapid Influenza Diagnostic Test during H1N1 2009 Influenza Pandemic
2009 Vol.25 NO.11
Correspondence Author： Tsung-Wen Kuo
In order to evaluate the effect of changes in the proportion of H1N1 2009 influenza among influenza-like illness (ILI) to the direct medical cost associated with different strategies of administering Tamiflu to patients with ILI, a decision tree was constructed to compare the direct cost of two strategies of administering Tamiflu. Baseline parameter values used in the analysis were obtained from literature review and data from Centers for Disease Control and Department of Health, Taiwan. One- and two-way sensitivity analyses were performed to test the effect of changes in parameter values on the outcome of the two strategies.
Administering Tamiflu to patients with ILI according to results of rapid influenza diagnostic test is more economical than to all patients with ILI without performing rapid test based on the current proportion of H1N1 2009 influenza among ILI of 35% in Taiwan. Administering Tamiflu to all patients with ILI is more cost-effective when the fraction of H1N1 2009 influenza among ILI exceeds 54%, or when the average cost of hospitalization due to complications from H1N1 2009 influenza exceeds $218,000. The benefit of administering Tamiflu to all patients with ILI is more evident when the average cost of hospitalization or the probability of hospitalization due to complications is high.
Guidelines for Tamiflu administration should be modified based on the course of H1N1 2009 influenza pandemic. As the proportion of H1N1 2009 influenza among ILI continues to rise, it may be more appropriate to administer Tamiflu to patients with ILI regardless of rapid test results when necessary. To patients with suspected influenza illness who are at increased risk for complications, empirical Tamiflu treatment should be given as early as possible to reduce the risk of developing severe disease.
Keywords: H1N1 2009 influenza, rapid influenza diagnostic test, Tamiflu, cost analysis