Reducing the Transmission and Annual Burden of Influenza in the UK With Baloxavir Marboxil: A Cost-Effectiveness Analysis Using Evidence From the CENTERSTONE Trial
Author(s)
Svenn Alexander Kommandantvold, MASc, MPhil1, Chris Skedgel, MA, PhD2, Jeff Frimpter, MPH3, Hassan Zaraket, MD4, Hao Zhou, PhD5, Kunal Samanta, PhD6, Marie-Helene Blanchet Zumofen, PhD, MBA7.
1Roche Products Ltd, Oslo, Norway, 2Office of Health Economics, London, United Kingdom, 3Principal, Nucleus Global, an Inizio Company, San Francisco, CA, USA, 4Roche Products Ltd, Welwyn Garden City, United Kingdom, 5Genentech Inc, South San Francisco, CA, USA, 6Roche, Basel, Switzerland, 7F. Hoffmann-La Roche Ltd, Basel, Switzerland.
1Roche Products Ltd, Oslo, Norway, 2Office of Health Economics, London, United Kingdom, 3Principal, Nucleus Global, an Inizio Company, San Francisco, CA, USA, 4Roche Products Ltd, Welwyn Garden City, United Kingdom, 5Genentech Inc, South San Francisco, CA, USA, 6Roche, Basel, Switzerland, 7F. Hoffmann-La Roche Ltd, Basel, Switzerland.
OBJECTIVES: Baloxavir marboxil is a single-dose oral antiviral treatment that reduces the duration of influenza symptoms, rapidly stops viral shedding, and is approved for uncomplicated influenza in >80 countries worldwide. Baloxavir significantly reduced influenza transmission among household contacts within 5 days of treatment vs placebo (29% adjusted relative risk reduction) in the phase 3 CENTERSTONE trial (NCT03969212). We estimated the cost-effectiveness of reducing influenza transmission with baloxavir in the UK based on findings from CENTERSTONE.
METHODS: We estimated 8.4 million influenza cases annually in the UK with a 17% seasonal influenza antiviral treatment rate (high-risk patients, 30%; otherwise healthy individuals, 12%). The model used a 6% reduction in overall population transmission with baloxavir from adjusted CENTERSTONE data to reflect real-world expectations that not all individuals would receive antiviral treatment. The base case assumed no transmission reduction with oseltamivir or without antiviral treatment based on published studies. Other model inputs were from the literature. Outcomes included influenza infections, general practitioner visits, hospitalizations, and deaths. Costs were adjusted to 2024 GBP. Sensitivity and scenario analyses explored the societal impact and robustness of results.
RESULTS: Total annual costs of influenza without antiviral treatment were £1.093 billion. Baloxavir prevented 475,090 influenza cases and 48,527 influenza-related general practitioner visits per year vs no antiviral treatment or oseltamivir. Baloxavir was dominant vs no antiviral treatment, providing £20.3 million in cost savings and 84,372 additional quality-adjusted life-years (QALYs). Compared with oseltamivir, baloxavir added £56.8 million in treatment costs with 24,425 additional QALYs (incremental cost effectiveness ratio, £2,324/QALY). Results were driven by a reduction in annual influenza cases and lower risk of complications and hospitalization (-£153.5 million vs no treatment, -£54.5 million vs oseltamivir) with baloxavir.
CONCLUSIONS: Baloxavir could prevent nearly 500,000 seasonal influenza cases in the UK and was cost-effective vs no antiviral treatment or oseltamivir.
METHODS: We estimated 8.4 million influenza cases annually in the UK with a 17% seasonal influenza antiviral treatment rate (high-risk patients, 30%; otherwise healthy individuals, 12%). The model used a 6% reduction in overall population transmission with baloxavir from adjusted CENTERSTONE data to reflect real-world expectations that not all individuals would receive antiviral treatment. The base case assumed no transmission reduction with oseltamivir or without antiviral treatment based on published studies. Other model inputs were from the literature. Outcomes included influenza infections, general practitioner visits, hospitalizations, and deaths. Costs were adjusted to 2024 GBP. Sensitivity and scenario analyses explored the societal impact and robustness of results.
RESULTS: Total annual costs of influenza without antiviral treatment were £1.093 billion. Baloxavir prevented 475,090 influenza cases and 48,527 influenza-related general practitioner visits per year vs no antiviral treatment or oseltamivir. Baloxavir was dominant vs no antiviral treatment, providing £20.3 million in cost savings and 84,372 additional quality-adjusted life-years (QALYs). Compared with oseltamivir, baloxavir added £56.8 million in treatment costs with 24,425 additional QALYs (incremental cost effectiveness ratio, £2,324/QALY). Results were driven by a reduction in annual influenza cases and lower risk of complications and hospitalization (-£153.5 million vs no treatment, -£54.5 million vs oseltamivir) with baloxavir.
CONCLUSIONS: Baloxavir could prevent nearly 500,000 seasonal influenza cases in the UK and was cost-effective vs no antiviral treatment or oseltamivir.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE644
Topic
Economic Evaluation, Health Technology Assessment, Medical Technologies
Topic Subcategory
Trial-Based Economic Evaluation, Work & Home Productivity - Indirect Costs
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas