Volume 17, Number 9—September 2011
Research
Estimating Effect of Antiviral Drug Use during Pandemic (H1N1) 2009 Outbreak, United States
Table 4
Influenza antiviral drug* | No. prescriptions, by patient age group† |
Total | ||
---|---|---|---|---|
0–17 y | 18–64 y | >65 y | ||
Oseltamivir | 2,152,915 | 2,979,711 | 297,700 | 5,430,326 |
Zanamivir |
57,065 |
78,980 |
7,891 |
143,936 |
Subtotal‡ | 2,209,980 | 3,058,690 | 305,591 | 5,574,262 |
*These antiviral drugs were prescribed in a variety of forms (e.g., capsules, tablets, syrup, and inhaled powder). The estimated numbers came from the IMS database (3), which records ≈73% of all prescriptions filled by >50,000 US-based retail pharmacies. IMS then proportionately extrapolates their data, based on populations served by pharmacies, to provide weekly estimates of all prescriptions filled in the U.S. for these drugs. The IMS Health Xponent database does not cover in-hospital prescriptions.
†These subtotals, by age group, are the estimates of prescriptions filled to treat pandemic (H1N1) 2009–related clinical illness, after removing the prescriptions filled for prophylaxis and for patients who failed to adhere to drug regimen or prescriptions filled for personal stockpiles (see Table 1). The total number of prescriptions filled, before adjustments, was 8,177,542 (Table 1). Note that ≈3% of prescriptions filled during this period did not have age of patient recorded, and we omitted those prescriptions from our calculations.
‡These subtotals, by age group, were the estimates used to calculate the hospitalizations averted as shown in Table 5.
References
- Shrestha SS, Swerdlow DL, Borse RH, Prabhu VS, Finelli L, Atkins CY. Estimating the burden of 2009 pandemic influenza A (H1N1) in the United States (April 2009–April 2010). Clin Infect Dis. 2011;52(Suppl 1):S75–82. DOIPubMedGoogle Scholar
- Centers for Disease Control and Prevention. Updated interim recommendations for the use of antiviral medications in the treatment and prevention of influenza for the 2009–2010 season [cited 2010 Dec 18]. http://www.cdc.gov/H1N1flu/recommendations.htm#d
- Health IMS. Data Assets, IMS Prescription Data [cited 2010 Dec 18]. http://www.imshealth.com/portal/site/imshealth/menuitem.a46c6d4df3db4b3d88f611019418c22a/?vgnextoid=a4284c30aaaa0210VgnVCM100000ed152ca2RCRD&vgnextchannel=bc42650204850210VgnVCM100000ed152ca2RCRD&vgnextfmt=default
- Reed C, Angulo FJ, Swerdlow DL, Lipsitch M, Meltzer MI, Jernigan D. Estimates of the prevalence of pandemic (H1N1) 2009, United States, April–July 2009. Emerg Infect Dis. 2009;15:2004–7. DOIPubMedGoogle Scholar
- Strong M, Burrows J, Stedman E, Redgrave P. Adverse drug effects following oseltamivir mass treatment and prophylaxis in a school outbreak of 2009 pandemic influenza A(H1N1) in June 2009, Sheffield, United Kingdom. Euro Surveill 2010;15:pii:19565.
- Kitching A, Roche A, Balasegaram S, Heathcock R, Maguire H. Oseltamivir adherence and side effects among children in three London schools affected by influenza A(H1N1)v, May 2009—an internet-based cross-sectional survey. Euro Surveill. 2009;14:pii:19287.
- Kaiser L, Wat C, Mills T, Mahoney P, Ward P, Hayden F. Impact of oseltamivir treatment on influenza-related lower respiratory tract complications and hospitalizations. Arch Intern Med. 2003;163:1667–72. DOIPubMedGoogle Scholar
- Blumentals WA, Schulman KL. Impact of oseltamivir on the incidence of secondary complications of influenza in adolescent and adult patients: results from a retrospective population-based study. Curr Med Res Opin. 2007;23:2961–70. DOIPubMedGoogle Scholar
- Gums JG, Pelletier EM, Blumentals WA. Oseltamivir and influenza-related complications, hospitalization and healthcare expenditure in healthy adults and children. Expert Opin Pharmacother. 2008;9:151–61. DOIPubMedGoogle Scholar
- Orzeck EA, Shi N, Blumentals WA. Oseltamivir and the risk of influenza-related complications and hospitalizations in patients with diabetes. Clin Ther. 2007;29:2246–55. DOIPubMedGoogle Scholar
- Peters PH, Moscona A, Schulman KL, Barr CE. Study of the impact of oseltamivir on the risk for pneumonia and other outcomes of influenza, 2000–2005. Medscape J Med. 2008;10:131.PubMedGoogle Scholar
- Mäkelä MJ, Pauksens K, Rostila T, Fleming DM, Man CY, Keene ON. Clinical efficacy and safety of the orally inhaled neuraminidase inhibitor zanamivir in the treatment of influenza: a randomized, double-blind, placebo-controlled European study. J Infect. 2000;40:42–8. DOIPubMedGoogle Scholar
- Hayden FG, Sperber SJ, Belshe RB, Clover RD, Hay AJ, Pyke S. Recovery of drug-resistant influenza A virus during therapeutic use of rimantadine. Antimicrob Agents Chemother. 1991;35:1741–7.PubMedGoogle Scholar
- The MIST. (Management of Influenza in the Southern Hemisphere Trialists) Study Group. Randomised trial of efficacy and safety of inhaled zanamivir in treatment of influenza A and B virus infections. Lancet. 1998;352:1877–81.PubMedGoogle Scholar
- Aoki FY, Macleod MD, Paggiaro P, Carewicz O, Sawy AE, Wat C. Early administration of oral oseltamivir increases the benefits of influenza treatment. J Antimicrob Chemother. 2003;51:123–9. DOIPubMedGoogle Scholar
- Hayden FG, Osterhaus AD, Treanor JJ, Fleming DM, Aoki FY, Nicholson KG. Efficacy and safety of the neuraminidase inhibitor zanamivir in the treatment of influenzavirus infections. GG167 Influenza Study Group. N Engl J Med. 1997;337:874–80. DOIPubMedGoogle Scholar
- Lalezari J, Campion K, Keene O, Silagy C. Zanamivir for the treatment of influenza A and B infection in high-risk patients: a pooled analysis of randomized controlled trials. Arch Intern Med. 2001;161:212–7. DOIPubMedGoogle Scholar
- Monto AS, Moult AB, Sharp SJ. Effect of zanamivir on duration and resolution of influenza symptoms. Clin Ther. 2000;22:1294–305. DOIPubMedGoogle Scholar
- Nicholson KG, Aoki FY, Osterhaus AD, Trottier S, Carewicz O, Mercier CH. Efficacy and safety of oseltamivir in treatment of acute influenza: a randomised controlled trial. Neuraminidase Inhibitor Flu Treatment Investigator Group. Lancet. 2000;355:1845–50. DOIPubMedGoogle Scholar
- Treanor JJ, Hayden FG, Vrooman PS, Barbarash R, Bettis R, Riff D. Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza: a randomized controlled trial. US Oral Neuraminidase Study Group. JAMA. 2000;283:1016–24. DOIPubMedGoogle Scholar
- Whitley RJ, Hayden FG, Reisinger KS, Young N, Dutkowski R, Ipe D. Oral oseltamivir treatment of influenza in children. Pediatr Infect Dis J. 2001;20:127–33. DOIPubMedGoogle Scholar
- Prosser LA, Meltzer MI, Fiore A, Epperson S, Bridges CB, Hinrichsen V. Effects of adverse events of the projected population benefits and cost-effectiveness of using live attenuated influenza vaccine in children aged 6 months to 4 years. Arch Pediatr Adolesc Med. 2011;165:112–8. DOIPubMedGoogle Scholar
- Beigi RH, Wiringa AE, Bailey RR, Assi T-M, Lee BY. Economic value of seasonal and pandemic influenza during pregnancy. Clin Infect Dis. 2009;49:1784–92. DOIPubMedGoogle Scholar
- Fairbrother G, Cassedy A, Ortega-Sanchez IR, Szilagyi PG, Edwards KM, Molinari N-A. High costs of infleunza: direct medical costs of influenza disease in young children. Vaccine. 2010;28:4913–9. DOIPubMedGoogle Scholar
- Keren R, Zaoutis TE, Saddlemire S, Luan XQ, Coffin SE. Direct medical costs of influenza-related hospitalizations in children. Pediatrics. 2007;119:227.
- Cox FM, Cobb MM, Chua WQ, McLaughlin TP, Okamoto LJ. Cost of treating influenza in emergency department and hospital settings. Am J Manag Care. 2000;6:205–14.PubMedGoogle Scholar