Antiviral medications for pregnant women for pandemic and seasonal influenza: an economic computer model.
Antiviral medications for pregnant women for pandemic and seasonal influenza: an economic computer model.
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DOI：
10.1097/aog.0b013e3181bdbfed
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发表时间：
2009-11
影响因子：
7.2
通讯作者：
Beigi RH
中科院分区：
文献类型：
--
作者：
Lee BY;Bailey RR;Wiringa AE;Assi TM;Beigi RH
为了估计与与流感流感的传染性人接触的孕妇使用抗病毒药的经济价值。
开发了一种计算机模拟模型，以预测抗病毒药使用在季节性流感和大流行性流感情景中抗病毒对暴露后预防的潜在经济影响。该模型使我们能够检查流感风险不同，抗病毒功效，抗病毒成本以及不同流感结果（例如住院，早产和死亡率）的可能性。
对于各种大流行性流感情景（攻击率为20％或以上，是流感12％或以上的女性早产的概率，早产2％或以上的死亡率，以及可流感促进住院的概率4.8％或更多） ，暴露后预防性抗病毒药药具有很高的成本效益，其成本效益比值逐渐低于$ 50,000根据质量调整的生活年度。当流感攻击率为20％或以上，早产率为36％或以上时，抗病毒预防成为一种经济主导的策略（即成本降低，更有效），而攻击率为30％或更早的出生率时在季节性流感疾病下，预防抗病毒预防不是成本效益。
这些发现支持在大流行性流感情景中使用抗病毒药物来预防暴露后预防，但在季节性流感环境中不使用。
To estimate the economic value of administering antiviral medications to pregnant women who have come in contact with an infectious individual with influenza. A computer-simulation model was developed to predict the potential economic effect of antiviral use for postexposure prophylaxis among pregnant women in both seasonal influenza and pandemic influenza scenarios. The model allowed us to examine the effects of varying influenza exposure risk, antiviral efficacy, antiviral cost, and the probability of different influenza outcomes such as hospitalization, preterm delivery, and mortality. For a variety of pandemic influenza scenarios (attack rate 20% or more, probability of preterm birth for women with influenza 12% or more, mortality for a preterm neonate 2% or more, and probability of influenza-attributable hospitalization 4.8% or more), the postexposure prophylactic use of antiviral medications was strongly cost-effective, with incremental cost-effectiveness ratio values below $50,000 per quality-adjusted life-year. Antiviral prophylaxis became an economically dominant strategy (that is, less costly and more effective) when the influenza attack rate is 20% or more and preterm birth rate is 36% or more, and when attack rate is 30% or more and preterm birth rate is 24% or more.Antiviral prophylaxis was not cost-effective under seasonal influenza conditions. These findings support the use of antiviral medications for postexposure prophylaxis among pregnant women in a pandemic influenza scenario but not in a seasonal influenza setting.