SEASONAL influenza, or flu, continues to impose a substantial burden on healthcare systems worldwide, with frequent hospitalisations and emergency department (ED) visits among at-risk populations. Recent data from a large USA cohort suggest that baloxavir, a single-dose antiviral, may offer notable advantages over traditional oseltamivir therapy in reducing healthcare utilisation.
Comparative Analysis of Baloxavir and Oseltamivir
A retrospective analysis included 73,899 influenza outpatients treated with oseltamivir and 1,592 treated with baloxavir, using data from the TriNetX US Collaborative Network encompassing 69 healthcare organisations. The study applied 1:1 propensity score matching to adjust for baseline differences and potential confounders.
Results demonstrated that baloxavir users experienced significantly lower rates of hospitalisation at 1, 3, and 6 months post-treatment (0.6%, 0.6%, and 0.8%) compared with oseltamivir-treated patients (1.6%, 3.7%, and 5.3%). Similarly, ED visits were reduced across all time points in the baloxavir group (1.5%, 3.5%, 5.0%) versus the oseltamivir group (1.8%, 4.4%, 7.2%). Mortality rates were comparable between the groups (0.6% for both), indicating that baloxavir’s reduction in hospitalisation and ED visits does not compromise patient survival.
Clinical Implications for Managing Flu Hospitalisations
These findings highlight baloxavir as a potent option for outpatient influenza management, particularly in high-risk patients where reducing hospital and ED utilisation is critical. Its single-dose regimen may also improve adherence compared with the multi-day oseltamivir course, further enhancing its clinical effectiveness.
For clinicians, this study reinforces the value of integrating baloxavir into treatment protocols during peak flu seasons. While mortality remains similar, the reductions in hospitalisations and ED visits could translate to lower healthcare costs, improved patient convenience, and decreased strain on healthcare systems.
Overall, baloxavir represents an effective strategy for mitigating influenza’s clinical and logistical burden, supporting its broader adoption in outpatient influenza care. Further studies may clarify subgroup benefits and optimise antiviral selection in diverse patient populations.
Reference
Huang CH et al. Comparison of clinical outcomes of oseltamivir versus baloxavir in outpatients with influenza: a retrospective cohort analysis. Int J Infect Dis. 2025; DOI:10.1016/j.ijid.2025.108277.
