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The Cost Effectiveness of Pandemic Influenza Interventions: A Pandemic Severity Based Analysis

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  • George J Milne
  • Nilimesh Halder
  • Joel K Kelso

Abstract

Background: The impact of a newly emerged influenza pandemic will depend on its transmissibility and severity. Understanding how these pandemic features impact on the effectiveness and cost effectiveness of alternative intervention strategies is important for pandemic planning. Methods: A cost effectiveness analysis of a comprehensive range of social distancing and antiviral drug strategies intended to mitigate a future pandemic was conducted using a simulation model of a community of ∼30,000 in Australia. Six pandemic severity categories were defined based on case fatality ratio (CFR), using data from the 2009/2010 pandemic to relate hospitalisation rates to CFR. Results: Intervention strategies combining school closure with antiviral treatment and prophylaxis are the most cost effective strategies in terms of cost per life year saved (LYS) for all severity categories. The cost component in the cost per LYS ratio varies depending on pandemic severity: for a severe pandemic (CFR of 2.5%) the cost is ∼$9 k per LYS; for a low severity pandemic (CFR of 0.1%) this strategy costs ∼$58 k per LYS; for a pandemic with very low severity similar to the 2009 pandemic (CFR of 0.03%) the cost is ∼$155 per LYS. With high severity pandemics (CFR >0.75%) the most effective attack rate reduction strategies are also the most cost effective. During low severity pandemics costs are dominated by productivity losses due to illness and social distancing interventions, while for high severity pandemics costs are dominated by hospitalisation costs and productivity losses due to death. Conclusions: The most cost effective strategies for mitigating an influenza pandemic involve combining sustained social distancing with the use of antiviral agents. For low severity pandemics the most cost effective strategies involve antiviral treatment, prophylaxis and short durations of school closure; while these are cost effective they are less effective than other strategies in reducing the infection rate.

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  • George J Milne & Nilimesh Halder & Joel K Kelso, 2013. "The Cost Effectiveness of Pandemic Influenza Interventions: A Pandemic Severity Based Analysis," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-16, April.
    • Handle: RePEc:plo:pone00:0061504
    DOI: 10.1371/journal.pone.0061504
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    Cited by:

    1. Toxvaerd, Flavio & Rowthorn, Robert, 2022. "On the management of population immunity," Journal of Economic Theory, Elsevier, vol. 204(C).
    2. Peter A.G. van Bergeijk, 2021. "Pandemic Economics," Books, Edward Elgar Publishing, number 20401.
    3. Janetta E. Skarp & Laura E. Downey & Julius W. E. Ohrnberger & Lucia Cilloni & Alexandra B. Hogan & Abagael L. Sykes & Susannah S. Wang & Hiral Anil Shah & Mimi Xiao & Katharina Hauck, 2021. "A Systematic Review of the Costs Relating to Non-pharmaceutical Interventions Against Infectious Disease Outbreaks," Applied Health Economics and Health Policy, Springer, vol. 19(5), pages 673-697, September.
    4. Auliya A. Suwantika & Neily Zakiyah & Ajeng Diantini & Rizky Abdulah & Maarten J. Postma, 2020. "The Role of Administrative and Secondary Data in Estimating the Costs and Effects of School and Workplace Closures due to the COVID-19 Pandemic," Data, MDPI, vol. 5(4), pages 1-11, October.

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