There is insufficient evidence that oseltamivir reduces complications, hospitalizations and/or death in individuals suspected of having influenza. In addition, there is insufficient evidence of any benefit in individuals with suspected influenza who are at risk for developing complications. Evidence from one trial suggests that otherwise healthy individuals suspected of having influenza, return to normal activity faster when treated with oseltamivir than those receiving placebo. No studies are available to compare the magnitude of this benefit to amantadine, zanamivir or symptom-relieving medications.
The economic analysis suggests that, from a government payer perspective, oseltamivir is unlikely to be cost-effective for treating suspected influenza in otherwise healthy adults, based on reasonable assumptions about diagnostic accuracy in a primary care setting when influenza is circulating in the community. It would appear that oseltamivir is also unlikely to be a cost-effective treatment for adults at risk of developing influenza-related complications - but the clinical evidence for this is inconclusive at this time.
Another cause for concern is the likelihood of primary care consultations from patients with little risk of complications who would not otherwise seek treatment. If oseltamivir were to be reimbursed by a government payer, additional budgetary resources would have to be allocated since it is unlikely to be a cost-saving strategy.
