Cost-effectiveness of baloxavir marboxil compared to laninamivir for the treatment of influenza in Japan. Issue 2 (February 2021)

• Record Type: Journal Article
• Authors: Skrzeczek, Aleksandra; Ikeoka, Hidetoshi; Hirotsu, Nobuo; Ansaripour, Amir; Aballéa, Samuel; Onishi, Yoshie; Hill, Mark; Igarashi, Ataru
• Is Part Of: Journal of infection and chemotherapy. Volume 27:Issue 2(2021)
• Page Start: 296
• Page End: 305
• Publication Date: 2021-02
• Subjects: Baloxavir marboxil -- Cost-effectiveness analysis -- Laninamivir -- Influenza -- Otherwise healthy adults -- Japan; OwH otherwise healthy -- QALYs quality-adjusted life-years -- DRAEs drug-related adverse events -- NAIs neuraminidase inhibitors -- RIDT rapid influenza diagnostic test -- ICER incremental cost effectiveness ratio -- NMA network meta-analysis -- HTA health technology assessment -- WTP willingness-to-pay -- DSA deterministic sensitivity analysis -- PSA probabilistic sensitivity analysis; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2020.10.018
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: Background: Baloxavir marboxil (baloxavir) is a new oral antiviral for influenza types A and B. Objectives: To determine the cost-effectiveness of baloxavir versus laninamivir in otherwise healthy (OwH) adults in Japan. Methods: A decision tree was utilized to describe the course of influenza and predict associated costs and quality-adjusted life-years (QALYs) over one year by antiviral. Costs were valued from the public healthcare payer perspective, including influenza test, antiviral acquisition, other medications, physician visits, other outpatient costs associated with influenza or drug-related adverse events (DRAEs), and hospitalizations. Resource utilization and unit costs were obtained from the analysis of the JammNet claims database. Health state utilities were obtained from a clinical trial of baloxavir and previous models, and were driven by influenza symptoms, DRAEs, and complications caused by influenza. Sensitivity analyses were also performed. Results: The total payer expenditure per patient for baloxavir versus laninamivir was ¥9383 versus ¥9132. The additional acquisition costs of baloxavir were partly offset by the DRAE costs avoided. Baloxavir showed a small gain in QALYs versus laninamivir and the incremental cost per QALY gained (¥2, 231, 260) was lower than the considered willingness-to-pay threshold (¥5, 000, 000/QALY). Key model drivers were the probability of DRAEs and the duration of symptoms. The probability of baloxavir being cost-effective was 64%. Conclusion: This cost-effectiveness study on baloxavir suggests that it would be cost-effective compared to laninamivir in OwH adults in Japan. Further studies are needed in different settings such as high-risk population and with different comparators.