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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 3.

ICERs of Different Intravenous Antiviral Strategies in the Nonventilated 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 802 800 790
IV antiviral cost of $500 per day
 Give no IV antiviral agent — — —
 PCR testing, then start IV antiviral agents 1733 1484 1301
 Start IV antiviral agents, then PCR testing 198,370 198,370 198,370
 Give IV antiviral agents 4266 4201 4236
IV antiviral cost of $1000 per day
 Give no IV antiviral agent — — —
 PCR testing, then start IV antiviral agents 6438 5473 5176
 Start IV antiviral agents, then PCR testing 396,739 396,739 396,739
 Give IV antiviral agents 8666 8596 8536
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 789 794 797
IV antiviral cost of $500 per day
 Give no IV antiviral agent — — —
 PCR testing, then start IV antiviral agents 1499 1171 972
 Start IV antiviral agents, then PCR testing 198,370 198,370 198,370
 Give IV antiviral agents 4310 4202 4290
IV antiviral cost of $1000 per day
 Give no IV antiviral agent — — —
 PCR testing, then start IV antiviral agents 5554 4732 3876
 Start IV antiviral agents, then PCR testing 396,739 396,739 396,739
 Give IV antiviral agents 8506 8553 8571

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.