Pan-canadian public health network council report and policy recommendations on the use of antivirals for prophylaxis during an influenza pandemic

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Key Considerations and Expert Reviews

9. Economic Considerations

An economic analysis awaits a policy decision on the use of antivirals for prophylaxis during an influenza pandemic. As part of its scientific assessment, CADTH produced an interim analysis for TGAP on the cost effectiveness of antiviral prophylaxis for influenza.

Key Findings

Of the studies included in the CADTH analysis (based on one CADTH report and eight other reviews), the one with the highest quality and transparency estimated the cost-effectiveness of prophylaxis for healthy adults, at risk populations, elderly populations in residential care and children, for amantadine and the neuraminidase inhibitors (zanamivir and oseltamivir). It concluded that “antiviral prophylaxis appears cost-effective only for the residential care elderly population” using amantadine and subject to a number of influential factors. Neuraminidase

inhibitors were considered effective against both influenza A and B, with fewer adverse effects, slightly higher effectiveness and lower rates of development of resistance. However, the cost of amantadine is much lower. There was limited evidence on the cost-effectiveness of zanamivir, but oseltamivir appears to be the more cost-effective of the two.

Conclusions

Once there is agreement in principle on a policy direction, review and analysis will be required to assess the overall size and cost of any potential additions to the NAS stockpile.

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