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Open Access Highly Accessed Research article

Oseltamivir use and outcomes during the 2009 influenza A H1N1 pandemic in Taiwan

Chia-Hung Liu12, Jiun-Ling Wang3, Chia-Ping Su4, Jen-Hsiang Chuang4, Chia-Hsuin Chang15* and Mei-Shu Lai1*

Author Affiliations

1 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan

2 Department of Family Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan

3 Department of Internal Medicine, E-Da hospital/ I-Shou University, Kaohsiung, Taiwan

4 Taiwan Centers for Disease Control, Taipei, Taiwan

5 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

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BMC Public Health 2013, 13:646  doi:10.1186/1471-2458-13-646

Published: 12 July 2013

Abstract

Background

The Taiwan CDC provided free oseltamivir to all patients with influenza infections confirmed by rapid testing or who had clinical warning symptoms during the 2009 H1N1 influenza pandemic in Taiwan. However, oseltamivir utilization patterns, cost, and outcomes among oseltamivir-treated patients remained unclear.

Method

A population-level, observational cohort study was conducted using the Taiwan National Health Insurance Database from January to December 2009 to describe the use of oseltamivir.

Result

Prescription trend over weeks increased after a change in government policy and responded to the influenza virus activity. The overall prescription rate was 22.33 per 1000 persons, with the highest prescription rate of 116.5 for those aged 7–12 years, followed by 69.0 for those aged 13–18 years, while the lowest rate was 1.7 for those aged ≥ 65 years. As influenza virus activity increased, the number of prescriptions for those aged ≤18 years rose significantly, whereas no substantial change was observed for those aged ≥65 years. There were also regional variations in terms of oseltamivir utilization and influenza complication rates.

Conclusions

Oseltamivir was widely used in the 2009 H1N1 influenza pandemic in Taiwan, particularly in those aged 7–18 years. The number of prescriptions for oseltamivir increased with a change in government policy and with increasing cases of pandemic influenza. Further study is needed to examine whether there is an over- or under-use of anti-influenza drugs in different age groups or regions and to examine the current policy of public use of anti-influenza drugs to reduce influenza-associated morbidity and mortality.

Keywords:
Oseltamivir; Influenza A virus; H1N1 subtype; Pandemic; Mortality