ABSTRACT
Background: The coronavirus, COVID-19, has caused a global pandemic of an unprecedented scale. The efficacy of antivirals and other drugs, considered for repurposing, is assessed in clinical trials. It is not clear, however, whether these treatments, when available, will be cost effective. Purpose(s): To systematically review published economic evaluations of antivirals for the management of pandemic influenza. Method(s): The following databases were searched from inception to 26 March 2020: Medline (EBSCO HOST), EMBASE (OVID), EconLit (OVID), NHS EED (OVID) and HTA (OVID). Citation tracking and reference checking were also used. Only full economic evaluations published in the last ten years were included. Studies were quality assessed using NICE economic evaluation checklist. Data were extracted into standard data extraction tables and narratively summarised. Result(s): Of 709 records identified, 14 studies were included. These were mostly conducted in high income countries. They were seven (50.0%) cost-utility analyses, four (28.6%) cost-effectiveness analyses, two (14.3%) cost-consequences analyses, and one (7.1%) cost-benefit analysis. Antiviral treatment-containing strategies were found to be either cost saving or cost effective. Empirical treatment was more cost effective than test-guided treatment for young adults but less for older adults. Infection rate, prevalence, antiviral efficacy and costs were the key drivers of cost effectiveness Conclusion(s): Antiviral treatment for managing pandemic influenza viruses that have high case fatality rate, similar to the COVID-19 pandemic, has shown to be cost effective, either as standalone intervention or part of a multifaceted strategy.