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Publications [#278746] of Dennis A. Clements

Papers Published

  1. Lee, PY; Matchar, DB; Clements, DA; Huber, J; Hamilton, JD; Peterson, ED, Economic analysis of influenza vaccination and antiviral treatment for healthy working adults., Annals of Internal Medicine, vol. 137 no. 4 (August, 2002), pp. 225-231, ISSN 1539-3704 [12186512], [doi]
    (last updated on 2019/05/23)

    BACKGROUND: Physicians have several treatment options for influenza, including vaccination and various antiviral therapies. However, the optimal influenza prevention and treatment strategy is unknown. OBJECTIVE: To compare the relative health values of contemporary treatment strategies for influenza in a healthy sample of working adults. DESIGN: Cost-benefit analysis using a decision model. DATA SOURCES: Previously published data. TARGET POPULATION: Healthy employed adults 18 to 50 years of age. TIME HORIZON: A complete influenza season. PERSPECTIVE: Societal. INTERVENTIONS: Eight treatment options (yes or no) based on the possible combinations of vaccination and antiviral therapy (rimantadine, oseltamivir, or zanamivir or no treatment) should infection develop. OUTCOME MEASURES: Cost in U.S. dollars, including the value of symptom relief and medication side effects, which was assigned a monetary value through a conjoint analysis that used a "willingness-to-pay" approach. RESULTS: In the base-case analysis, all strategies for influenza vaccination had a higher net benefit than the nonvaccination strategies. Vaccination and use of rimantadine, the most cost-beneficial strategy, was $30.97 more cost-beneficial than nonvaccination and no use of antiviral medication. The health benefits of most antiviral treatments equaled or exceeded their costs for most scenarios. The choice of the most cost-beneficial antiviral strategy was sensitive to the prevalence of influenza B and to the comparative workdays gained by each antiviral therapy. CONCLUSIONS: Vaccination is cost-beneficial in most influenza seasons in healthy working adults. Although the benefits of antiviral therapy for persons with influenza infection appear to justify its cost, head-to-head trials of the various antiviral therapies are needed to determine the optimal treatment strategy.

    Acetamides • Adolescent • Adult • Antiviral Agents • Computer Simulation • Cost of Illness • Cost-Benefit Analysis • Decision Trees • Drug Costs • Guanidines • Humans • Influenza Vaccines • Influenza, Human • Middle Aged • Oseltamivir • Pyrans • Rimantadine • Sensitivity and Specificity • Sialic Acids • Vaccination • Zanamivir • adverse effects • drug therapy* • economics • economics* • prevention & control* • therapeutic use

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