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Infectious Diseases and Therapy

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Open Access 14-03-2024 | Oseltamivir | Original Research

Household Influenza Transmission and Healthcare Resource Utilization Among Patients Treated with Baloxavir vs Oseltamivir: A United States Outpatient Prospective Survey

Authors: Jennie H. Best, Mitra Sadeghi, Xiaowu Sun, Arpamas Seetasith, Lisa Albensi, Seema Joshi, Marcus J. Zervos

Published in: Infectious Diseases and Therapy | Issue 4/2024

Abstract

Introduction

Influenza is a common, seasonal infectious disease with broad medical, economic, and social consequences. Real-world evidence on the effect of influenza treatment on household transmission and healthcare resource utilization is limited in outpatient settings in the USA. This study examined the real-world effectiveness of baloxavir vs oseltamivir in reducing influenza household transmission and healthcare resource utilization.

Methods

This prospective electronic survey on patient-reported outcomes was conducted between October 2022 and May 2023 via CVS Pharmacy in the USA. Adult participants (≥ 18 years old) were eligible if they filled a prescription for baloxavir or oseltamivir at a CVS Pharmacy within 2 days of influenza symptom onset. Participant demographics, household transmission, and all-cause healthcare resource utilization were collected. Transmission and utilization outcomes were assessed using χ² and Fisher exact tests.

Results

Of 87,871 unique patients contacted, 1346 (1.5%) consented. Of 374 eligible patients, 286 (90 baloxavir- and 196 oseltamivir-treated patients) completed the survey and were included in the analysis. Mean age of participants was 45.4 years, 65.6% were female, and 86.7% were White. Lower household transmission was observed with baloxavir compared with oseltamivir therapy (17.8% vs 26.5%; relative risk = 0.67; 95% CI 0.41–1.11). Healthcare resource utilization, particularly emergency department visits (0.0% vs 4.6%), was also numerically lower in the baloxavir-treated group; no hospitalizations were reported in either cohort.

Conclusions

The findings from this real-world study suggest that antiviral treatment of influenza with baloxavir may decrease household transmission and reduce healthcare resource utilization compared with oseltamivir.

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World Health Organization. Influenza (seasonal) 2023 [updated 1/12/2023]. https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)). Accessed 25 Oct 2023.

Monto AS. Epidemiology of influenza. Vaccine. 2008;26(Suppl 4):D45–8.CrossRefPubMed

Yan S, Weycker D, Sokolowski S. US healthcare costs attributable to type A and type B influenza. Hum Vaccin Immunother. 2017;13(9):2041–7.CrossRefPubMedPubMedCentral

Putri W, Muscatello DJ, Stockwell MS, Newall AT. Economic burden of seasonal influenza in the United States. Vaccine. 2018;36(27):3960–6.CrossRefPubMed

Goeyvaerts N, Santermans E, Potter G, et al. Household members do not contact each other at random: implications for infectious disease modelling. Proc Biol Sci. 1893;2018(285):20182201.

Ibuka Y, Ohkusa Y, Sugawara T, et al. Social contacts, vaccination decisions and influenza in Japan. J Epidemiol Community Health. 2016;70(2):162–7.CrossRefPubMed

Carrat F, Vergu E, Ferguson NM, et al. Time lines of infection and disease in human influenza: a review of volunteer challenge studies. Am J Epidemiol. 2008;167(7):775–85.CrossRefPubMed

World Health Organization Writing Group, Bell D, Nicoll A, et al. Non-pharmaceutical interventions for pandemic influenza, international measures. Emerg Infect Dis. 2006;12(1):81–7.CrossRefPubMedCentral

Halloran ME, Hayden FG, Yang Y, Longini IM Jr, Monto AS. Antiviral effects on influenza viral transmission and pathogenicity: observations from household-based trials. Am J Epidemiol. 2007;165(2):212–21.CrossRefPubMed

10.

Komeda T, Takazono T, Hosogaya N, et al. Comparison of household transmission of influenza virus from index patients treated with baloxavir marboxil or neuraminidase inhibitors: a health insurance claims database study. Clin Infect Dis. 2021;72(11):e859–67.CrossRefPubMed

11.

Miyazawa S, Takazono T, Hosogaya N, et al. Comparison of intra-familial transmission of influenza virus from index patients treated with baloxavir marboxil or oseltamivir using an influenza transmission model and a health insurance claims database. Clin Infect Dis. 2022;75(6):927–35.CrossRefPubMedPubMedCentral

12.

Hayden FG, Asher J, Cowling BJ, et al. Reducing influenza virus transmission: the potential value of antiviral treatment. Clin Infect Dis. 2022;74(3):532–40.CrossRefPubMed

13.

Ison MG. Clinical use of approved influenza antivirals: therapy and prophylaxis. Influenza Other Respir Viruses. 2013;7(Suppl 1):7–13.CrossRefPubMed

14.

Welliver R, Monto AS, Carewicz O, et al. Effectiveness of oseltamivir in preventing influenza in household contacts: a randomized controlled trial. JAMA. 2001;285(6):748–54.CrossRefPubMed

15.

Hayden FG, Sugaya N, Hirotsu N, et al. Baloxavir marboxil for uncomplicated influenza in adults and adolescents. N Engl J Med. 2018;379(10):913–23.CrossRefPubMed

16.

Ison MG, Portsmouth S, Yoshida Y, et al. Early treatment with baloxavir marboxil in high-risk adolescent and adult outpatients with uncomplicated influenza (CAPSTONE-2): a randomised, placebo-controlled, phase 3 trial. Lancet Infect Dis. 2020;20(10):1204–14.CrossRefPubMed

17.

Xofluza [prescribing information]. South San Francsico: Genentech, Inc; 2023. https://www.gene.com/download/pdf/xofluza_prescribing.pdf.

18.

Ikematsu H, Hayden FG, Kawaguchi K, et al. Baloxavir marboxil for prophylaxis against influenza in household contacts. N Engl J Med. 2020;383(4):309–20.CrossRefPubMed

19.

Powers JH 3rd, Bacci ED, Guerrero ML, et al. Reliability, validity, and responsiveness of InFLUenza patient-reported outcome (FLU-PRO©) scores in influenza-positive patients. Value Health. 2018;21(2):210–8.CrossRefPubMed

20.

Hunter V, Shapiro A, Chawla D, et al. Characterization of influenza-like illness burden using commercial wearable sensor data and patient-reported outcomes: mixed methods cohort study. J Med Internet Res. 2023;25:e41050.CrossRefPubMedPubMedCentral

21.

Oseltamivir [prescribing information]. South San Francisco CG, Inc. https://www.gene.com/download/pdf/tamiflu_prescribing.pdf]. Accessed 25 Oct 2023.

22.

CDC/ATSDR Social Vulnerability Index [updated 6/27/2023]. https://www.atsdr.cdc.gov/placeandhealth/svi/index.html. Accessed 26 Oct 2023.

23.

Wallick C, Abbass IM, Sheinson D, Moawad D. Healthcare resource use and burden associated with influenza transmission among household members with a primary infection: commercial claims data analysis. Clinicoecon Outcomes Res. 2021;13:335–42.CrossRefPubMedPubMedCentral

24.

Hirotsu N, Wada K, Oshitani H. Risk factors of household transmission of pandemic (H1N1) 2009 among patients treated with antivirals: a prospective study at a primary clinic in Japan. PLoS ONE. 2012;7(2):e31519.CrossRefPubMedPubMedCentral

25.

Nishiura H, Oshitani H. Household transmission of influenza (H1N1-2009) in Japan: age-specificity and reduction of household transmission risk by zanamivir treatment. J Int Med Res. 2011;39(2):619–28.CrossRefPubMed

26.

Pebody RG, Harris R, Kafatos G, et al. Use of antiviral drugs to reduce household transmission of pandemic (H1N1) 2009, United Kingdom. Emerg Infect Dis. 2011;17(6):990–9.CrossRefPubMedPubMedCentral

27.

ClinicalTrials.gov. Study to assess the efficacy of baloxavir marboxil versus placebo to reduce onward transmission of influenza A or B in households: ClinicalTrials.gov; 2023 [updated 6/23/2023]. https://classic.clinicaltrials.gov/ct2/show/NCT03969212. Accessed 27 Oct 2023.

28.

Ferguson NM, Cummings DA, Fraser C, Cajka JC, Cooley PC, Burke DS. Strategies for mitigating an influenza pandemic. Nature. 2006;442(7101):448–52.CrossRefPubMedPubMedCentral

29.

Chao DL, Halloran ME, Obenchain VJ, Longini IM Jr. FluTE, a publicly available stochastic influenza epidemic simulation model. PLoS Comput Biol. 2010;6(1):e1000656.CrossRefPubMedPubMedCentral

30.

Rolfes MA, Talbot HK, McLean HQ, et al. Household transmission of influenza A viruses in 2021–2022. JAMA. 2023;329(6):482–9.CrossRefPubMedPubMedCentral

31.

Dingle JH, Badger GF, Feller AE, Hodges RG, Jordan WS Jr, Rammelkamp CH Jr. A study of illness in a group of Cleveland families. I. Plan of study and certain general observations. Am J Hyg. 1953;58(1):16–30.PubMed

32.

Monto AS, Kioumehr F. The Tecumseh study of respiratory illness. IX. Occurence of influenza in the community, 1966–1971. Am J Epidemiol. 1975;102(6):553–63.CrossRefPubMed

33.

Monto AS. Studies of the community and family: acute respiratory illness and infection. Epidemiol Rev. 1994;16(2):351–73.CrossRefPubMed

34.

Cauchemez S, Donnelly CA, Reed C, et al. Household transmission of 2009 pandemic influenza A (H1N1) virus in the United States. N Engl J Med. 2009;361(27):2619–27.CrossRefPubMed

35.

Jackson ML, France AM, Hancock K, et al. Serologically confirmed household transmission of 2009 pandemic influenza A (H1N1) virus during the first pandemic wave—New York City, April–May 2009. Clin Infect Dis. 2011;53(5):455–62.CrossRefPubMed

36.

Goldstein E, Cowling BJ, O’Hagan JJ, et al. Oseltamivir for treatment and prevention of pandemic influenza A/H1N1 virus infection in households, Milwaukee, 2009. BMC Infect Dis. 2010;10:211.CrossRefPubMedPubMedCentral

37.

Lee N, Chan PK, Hui DS, et al. Viral loads and duration of viral shedding in adult patients hospitalized with influenza. J Infect Dis. 2009;200(4):492–500.CrossRefPubMed

38.

Neuberger E, Wallick C, Chawla D, Castro RC. Baloxavir vs oseltamivir: reduced utilization and costs in influenza. Am J Manag Care. 2022;28(3):e88–95.PubMed

39.

Noshi T, Kitano M, Taniguchi K, et al. In vitro characterization of baloxavir acid, a first-in-class cap-dependent endonuclease inhibitor of the influenza virus polymerase PA subunit. Antiviral Res. 2018;160:109–17.CrossRefPubMed

40.

Way N, Martin A, Wallick C, Neuberger E, Corral M. 1345. Patient perspectives and journey with influenza and seeking care from US National Survey. Open Forum Infect Dis. 2021;8:S759.CrossRefPubMedCentral

Title: Household Influenza Transmission and Healthcare Resource Utilization Among Patients Treated with Baloxavir vs Oseltamivir: A United States Outpatient Prospective Survey
Authors: Jennie H. Best
Mitra Sadeghi
Xiaowu Sun
Arpamas Seetasith
Lisa Albensi
Seema Joshi
Marcus J. Zervos
Publication date: 14-03-2024
Publisher: Springer Healthcare
Keywords: Oseltamivir
Influenza
Published in: Infectious Diseases and Therapy / Issue 4/2024
Print ISSN: 2193-8229
Electronic ISSN: 2193-6382
DOI: https://doi.org/10.1007/s40121-024-00937-y

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Abstract

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