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Volume 17, Number 9—September 2011
Research

Estimating Effect of Antiviral Drug Use during Pandemic (H1N1) 2009 Outbreak, United States

Charisma Y. Atkins, Anita Patel, Thomas H. Taylor, Matthew Biggerstaff, Toby L. Merlin, Stephanie M. Dulin, Benjamin A. Erickson, Rebekah H. Borse, Robert Hunkler, and Martin I. Meltzer
Author affiliations: Author affiliations: Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.Y. Atkins, A. Patel, T.H. Taylor, Jr., M. Biggerstaff, T.L. Merlin, S.M. Dulin, B.A. Erikson, R.H. Borse, M.I. Meltzer); IMS Health, Fountain Hills, Arizona, USA (R. Hunkler)

Main Article

Table 1

Number of pandemic (H1N1) 2009 cases versus number of influenza antiviral prescriptions filled during pandemic (H1N1) 2009 outbreak, United States, April 24, 2009–March 26, 2010*

Week† Mid-level estimate of cases‡ Filled influenza antiviral prescriptions
Oseltamivir Zanamivir Total
2009 Apr–Jul 3,052,768 1,243,827 69,513 1,313,340
2009 Aug
 1,605,760
 342,386
 11,645
 354,031
35 626,256 146,282 5,097 151,379
36 1,675,630 234,211 7,171 241,382
37 1,302,846 265,626 7,892 273,518
38 1,508,514 331,060 8,735 339,795
39 2,319,691 383,759 9,981 393,740
40 4,461,542 435,546 11,625 447,171
41 6,549,205 471,323 11,226 482,549
42 7,120,298 527,362 11,218 538,580
43 6,297,210 671,741 12,046 683,787
44 5,899,647 640,887 9,306 650,193
45 5,013,181 537,781 6,338 544,119
46 3,350,286 386,569 4,863 391,432
47 1,767,166 273,092 3,039 276,131
48 1,020,606 152,482 1,857 154,339
49 804,901 133,998 1,782 135,780
50 646,358 99,565 1,348 100,913
51 612,204 88,718 1,338 90,056
52 619,080 64,807 1,010 65,817
1 418,803 56,569 1,009 57,578
2 520,390 50,642 981 51,651
3 516,958 50,326 1,057 51,307
4 356,400 44,770 1,048 45,827
5 493,448 43,757 1,211 44,805
6 322,623 42,474 1,251 43,685
7 312,327 43,809 1,228 45,060
8 281,986 47,146 1,487 48,374
9 245,707 48,671 1,494 50,158
10 288,215 47,261 1,587 48,755
11 225,448 33,867 1,043 34,910
12
 312,575
 26,072
 730
 26,802
Total 60,548,030 7,966,386 211,156 8,177,542

*IMS Health Xponent database (3) includes 57,544 oseltamivir prescriptions and 877 zanamivir prescriptions for week 53. Because the Centers for Disease Control and Prevention only reports 52 weeks for 2009, we removed week 53 from the IMS data set (IMS, Norwalk, CT, USA).
†Estimates of cases for April–August 2009 are not available on a weekly basis.
‡Mid-level weekly cases estimated from (1) and www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm.

Main Article

References
  1. 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
  2. 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
  3. 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
  4. 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
  5. 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.
  6. 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.
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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
  17. 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
  18. Monto  AS, Moult  AB, Sharp  SJ. Effect of zanamivir on duration and resolution of influenza symptoms. Clin Ther. 2000;22:1294–305. DOIPubMedGoogle Scholar
  19. 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
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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
  25. Keren  R, Zaoutis  TE, Saddlemire  S, Luan  XQ, Coffin  SE. Direct medical costs of influenza-related hospitalizations in children. Pediatrics. 2007;119:227.
  26. 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

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Page created: June 19, 2012
Page updated: June 19, 2012
Page reviewed: June 19, 2012
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