Abstract
ObjectivesTwo recent meta-analyses by the York Health Economics Consortium (YHEC) and Cochrane demonstrated probiotic efficacy in reducing the duration and number of common respiratory tract infections (CRTI) and associated antibiotic prescriptions. A health-economic analysis was undertaken to estimate the public health and budget consequences of a generalized probiotic consumption in France.MethodsA virtual age- and gender-standardized population was generated using a Markov microsimulation model. CRTI risk factors incorporated into this model were age, active/passive smoking and living in a community setting. Incidence rates and resource utilization were based on the 2011-2012 flu season and retrieved from the French GPs Sentinelles network. Results of both meta-analyses were independently applied to the French population to estimate CRTI events, assuming a generalized probiotic use compared to no probiotics during winter months: -0.77 days/CRTI episode (YHEC scenario) or odds-ratio 0.58 for ≥1 CRTI episode (Cochrane scenario) with vs. without probiotics. Economic perspectives were National Health System (NHS), society, family. Outcomes included cost savings related to the reduced numbers of CRTI episodes, days of illness, number of antibiotic courses, sick leave days, medical and indirect costs.ResultsFor France, generalized probiotic use would save 2.4 million CRTI-days, 291,000 antibiotic courses and 581,000 sick leave days, based on YHEC data. Applying the Cochrane data, reductions were 6.6 million CRTI days, 473,000 antibiotic courses and 1.5 million sick days. From the NHS perspective, probiotics’ economic impact was about €14.6 million saved according to YHEC and €37.7 million according to Cochrane. Higher savings were observed in children, active smokers and people with more frequent human contacts.ConclusionsPublic health and budget impact of probiotics are substantial, whether they reduce CRTI episodes frequency or duration. Noteworthy, the 2011-12 winter CRTI incidence was low and this analysis focused on the fraction of CRTI patients consulting a practitioner.
Highlights
Common respiratory tract infections (CRTI) include common cold (CC), upper respiratory tract infections, influenza like illness (ILI) and flu [1,2,3]
Results of both meta-analyses were independently applied to the French population to estimate CRTI events, assuming a generalized probiotic use compared to no probiotics during winter months: -0.77 days/CRTI episode (YHEC scenario) or odds-ratio 0.58 for 1 CRTI episode (Cochrane scenario) with vs. without probiotics
The 2011-12 winter CRTI incidence was low and this analysis focused on the fraction of CRTI patients consulting a practitioner
Summary
Common respiratory tract infections (CRTI) include common cold (CC), upper respiratory tract infections, influenza like illness (ILI) and flu [1,2,3]. CRTI are mainly of viral origin, are contagious and transmitted via airborne droplets, direct contact or through contaminated objects [4,5]. Symptoms include runny nose, sneezing, sore throat, coughing, and sometimes fever, most of the time self-limited and usually resolving in seven to ten days. Adults have two to five infections annually and children typically present six to twelve “colds” per year [1, 6]. Rates of symptomatic infections increase in the elderly. Overlapping clinical presentations among influenza, CC, upper respiratory tract infections and flu make differential diagnosis difficult [7,8]
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