OBJECTIVES : Influenza places a significant burden on economies and healthcare systems causing substantial absenteeism. We estimated the benefits baloxavir can have on productivity costs, from a Swiss perspective.

METHODS : We used a combination of influenza epidemiological modelling and decision tree analysis to estimate baloxavir’s effect on absenteeism.

The epidemiological model consisted of a susceptible, exposed, infectious, recovered (SEIR) model, to estimate the impact of baloxavir’s reduction of time to cessation of viral shedding into the expected a number of infected subjects.

The number of infected subjects (treated and untreated) was then entered into the decision tree analysis, populated with branch probabilities and lost earnings as a proxy for absenteeism. We combined these data with hospital length of stay, convalescence data and premature death to calculate the indirect costs incurred by patients with influenza untreated or treated with baloxavir.

This analysis assumed 1 work day amounts to 286.-CHF, and a population of 8.5 Million inhabitants (66% working). We focused on an otherwise-healthy population and incorporated findings from the baloxavir CAPSTONE-1 trial and the literature to estimate the benefits that reducing symptom duration, complications, and disease transmission can have on absenteeism.

RESULTS : Deterministic analysis with our decision model estimated a total of 12bCHF lost earnings due to absenteeism or premature death if influenza patients are left untreated. Using baloxavir, we could achieve over 8bCHF savings: -610mCHF by reducing symptom duration (-1.7 days returning to normal health, from CAP-1 trial), -6.6bCHF if also reducing complications (5% absolute reduction, from NICE TA168 and CAP-1), -8.4bCHF if additionally reducing transmission (5% absolute reduction from SEIR model).

CONCLUSIONS : The benefits of use of baloxavir treatment within 2 days of symptom onset in reducing length of symptoms, complications, and transmission of the disease adds up to a considerable economic benefit across the working population of a country.