Neuraminidase inhibitors: Are they cost-effective?
Neuraminidase inhibitors have shown a reduction in time to resolution
of symptoms between 0.5 and 1.5 days; and reduction in time to resolution
of illness between 0.4 and 1.5 days. (1) All these figures have been
claimed to be statistically significant (P<0.05), but one question
remains unanswered- are these figures clinically significant too?
Moreover, with neuraminidase inhibitors, no reductions in asthma
exacerbations were seen. A very little (10%)/no change in antibiotic use
were observed. Even the incidence of acute otitis media in children aged 6
-12 years remained unchanged. Thus neuraminidase inhibitors were not
effective in reducing the complications of influenza.
Now the big question is-are neuraminidase inhibitors cost-effective?
Although no cost-effective analysis was done in the RCT included in the
meta-analysis, but attempt could have been made to make this review and
meta-analysis to deliver on this front also; that would have made this
meta-analysis, a cost-effective analysis also; a more fruitful study,
particularly in the wake of current pandemic of H1N1 influenza.
References
1. Shun-Shin M, Thompson M, Heneghan C, Perera R, Hamden A, Mant D.
Neuraminidase inhibitors for treatment and prophylaxis of influenza in
children: systematic review and meta-analysis of randomised controlled
trials. BMJ 2009; 339: b3172
Rapid Response:
Neuraminidase inhibitors: Are they cost-effective?
Neuraminidase inhibitors have shown a reduction in time to resolution
of symptoms between 0.5 and 1.5 days; and reduction in time to resolution
of illness between 0.4 and 1.5 days. (1) All these figures have been
claimed to be statistically significant (P<0.05), but one question
remains unanswered- are these figures clinically significant too?
Moreover, with neuraminidase inhibitors, no reductions in asthma
exacerbations were seen. A very little (10%)/no change in antibiotic use
were observed. Even the incidence of acute otitis media in children aged 6
-12 years remained unchanged. Thus neuraminidase inhibitors were not
effective in reducing the complications of influenza.
Now the big question is-are neuraminidase inhibitors cost-effective?
Although no cost-effective analysis was done in the RCT included in the
meta-analysis, but attempt could have been made to make this review and
meta-analysis to deliver on this front also; that would have made this
meta-analysis, a cost-effective analysis also; a more fruitful study,
particularly in the wake of current pandemic of H1N1 influenza.
References
1. Shun-Shin M, Thompson M, Heneghan C, Perera R, Hamden A, Mant D.
Neuraminidase inhibitors for treatment and prophylaxis of influenza in
children: systematic review and meta-analysis of randomised controlled
trials. BMJ 2009; 339: b3172
Competing interests:
None declared
Competing interests: No competing interests