# A cost-effectiveness analysis of baloxavir marboxil versus oseltamivir for seasonal influenza treatment in China

## TL;DR

This study compares the cost-effectiveness of two flu drugs in China and finds that baloxavir is cheaper and better for patient outcomes.

## Contribution

The study introduces a novel integration of a decision tree and transmission dynamics model for influenza treatment cost-effectiveness analysis in China.

## Key findings

- Baloxavir saves costs and improves quality-adjusted life years (QALYs) for both high-risk and healthy populations.
- Key cost drivers include hospitalization and ICU fatality rates for different population groups.
- Probabilistic analysis confirms the robustness of baloxavir's cost-effectiveness.

## Abstract

In this study, we aimed to evaluate the cost-effectiveness of baloxavir marboxil versus oseltamivir for treating seasonal influenza among both high-risk and otherwise healthy populations in China from the healthcare system perspective.

A decision tree model was constructed to evaluate the cost-effectiveness of two drugs. This model was integrated with a transmission dynamics model to assess the impact on controlling influenza spread. Model parameters for epidemiology, costs, and utilities were derived from real-world data on treatment costs from secondary and tertiary hospitals across China, the phase III clinical trial of baloxavir (CAPSTONE), and published literature.

Baloxavir was found to be a dominant strategy compared to oseltamivir in both populations, yielding lower costs and higher QALYs. For the high-risk population, baloxavir treatment would save $2.5468 per patient and gain an additional 0.00018 QALYs. In addition, for the otherwise healthy population, it would save $1.1278 per patient and gain an additional 0.00024 QALYs. One-way sensitivity analysis identified QALYs for influenza and hospitalization costs as the most influential parameters for the high-risk population, whereas the number of infections, ICU fatality rate, and hospitalization costs were key drivers for the otherwise healthy population. Probabilistic sensitivity analysis confirmed the robustness of these findings.

Baloxavir is a cost-effective alternative to oseltamivir for seasonal influenza treatment in China. It can improve patient outcomes and reduce influenza transmission at a societal level, offering value to the healthcare system.