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. Author manuscript; available in PMC: 2013 Sep 5.
Published in final edited form as: Am J Manag Care. 2011 Jan;17(1):e1–e9.

Table 2.

ICERs of Different Intravenous Antiviral Strategies in the Ventilated Population From the Third-Party Payer Perspectivea

Variable IV Antiviral Efficacy in Reducing Hospital Stay by 1 d, ICER
25% 50% 75%
Seasonal Influenza Scenario
IV antiviral cost of $100 per day
 PCR testing, then start IV antiviral agents — — —
 Start IV antiviral agents, then PCR testing 39,674 39,674 39,674
 Give no IV antiviral agent Dominated by start IV antiviral agents, then PCR testing Dominated by start IV antiviral agents, then PCR testing Dominated by start IV antiviral agents, then PCR testing
 Give IV antiviral agents 69 67 67
IV antiviral cost of $500 per day
 PCR testing, then start IV antiviral agents 41 — —
 Give no IV antiviral agent — Dominated by PCR testing, then start IV antiviral agents Dominated by PCR testing, then start IV antiviral agents
 Start IV antiviral agents, then PCR testing 198,370 198,370 198,370
 Give IV antiviral agents 360 366 369
IV antiviral cost of $1000 per day
 Give no IV antiviral agent — — —
 PCR testing, then start IV antiviral agents 331 154 53
 Start IV antiviral agents, then PCR testing 396,739 396,739 396,739
 Give IV antiviral agents 738 740 740
Pandemic Influenza Scenario With Twice the Seasonal Influenza Mortality
IV antiviral cost of $100 per day
 PCR testing, then start IV antiviral agents — — —
 Start IV antiviral agents, then PCR testing 39,674 39,674 39,674
 Give no IV antiviral agent Dominated by start IV antiviral agents, then PCR testing Dominated by start IV antiviral agents, then PCR testing Dominated by start IV antiviral agents, then PCR testing
 Give IV antiviral agents 68 68 68
IV antiviral cost of $500 per day
 PCR testing, then start IV antiviral agents 32 — —
 Give no IV antiviral agent — Dominated by PCR testing, then start IV antiviral agents Dominated by PCR testing, then start IV antiviral agents
 Start IV antiviral agents, then PCR testing 198,370 198,370 198,370
 Give IV antiviral agents 363 366 363
IV antiviral cost of $1000 per day
 Give no IV antiviral agent — — Dominated by PCR testing, then start IV antiviral agents
 PCR testing, then start IV antiviral agents 283 90 —
 Start IV antiviral agents, then PCR testing 396,739 396,739 396,739
 Give IV antiviral agents 739 736 736

ICER indicates incremental cost-effectiveness ratio (in US $ per QALY); IV, intravenous; PCR, polymerase chain reaction; QALY, quality-adjusted life-year.

a

In a patient aged 20 years (influenza prevalence, 10%) given 1 dose per day for a 5-day treatment course. Dash mark (—) indicates the best strategy compared with all other strategies.