Economic analysis of pandemic influenza mitigation strategies for five pandemic severity categories

BMC Public Health

George J Milne²  Maarten J Postma¹  Nilimesh Halder²  Joel K Kelso² 

[1] Unit of PharmacoEpidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, Netherlands;School of Computer Science and Software Engineering, University of Western Australia, Perth, Western Australia, Australia

关键词: Case fatality ratio;    Pandemic severity;    Social distancing;    Antiviral medication;    Economic analysis;    Pandemic influenza;   

Others  :  1162468
DOI  :  10.1186/1471-2458-13-211

 received in 2012-10-23, accepted in 2013-02-28,  发布年份 2013

【 摘 要 】

Background

The threat of emergence of a human-to-human transmissible strain of highly pathogenic influenza A(H5N1) is very real, and is reinforced by recent results showing that genetically modified A(H5N1) may be readily transmitted between ferrets. Public health authorities are hesitant in introducing social distancing interventions due to societal disruption and productivity losses. This study estimates the effectiveness and total cost (from a societal perspective, with a lifespan time horizon) of a comprehensive range of social distancing and antiviral drug strategies, under a range of pandemic severity categories.

Methods

An economic analysis was conducted using a simulation model of a community of ~30,000 in Australia. Data from the 2009 pandemic was used to derive relationships between the Case Fatality Rate (CFR) and hospitalization rates for each of five pandemic severity categories, with CFR ranging from 0.1% to 2.5%.

Results

For a pandemic with basic reproduction number R₀ = 1.8, adopting no interventions resulted in total costs ranging from $441 per person for a pandemic at category 1 (CFR 0.1%) to $8,550 per person at category 5 (CFR 2.5%). For severe pandemics of category 3 (CFR 0.75%) and greater, a strategy combining antiviral treatment and prophylaxis, extended school closure and community contact reduction resulted in the lowest total cost of any strategy, costing $1,584 per person at category 5. This strategy was highly effective, reducing the attack rate to 5%. With low severity pandemics costs are dominated by productivity losses due to illness and social distancing interventions, whereas higher severity pandemic costs are dominated by healthcare costs and costs arising from productivity losses due to death.

Conclusions

For pandemics in high severity categories the strategies with the lowest total cost to society involve rigorous, sustained social distancing, which are considered unacceptable for low severity pandemics due to societal disruption and cost.

【 授权许可】

   
2013 Kelso et al.; licensee BioMed Central Ltd.

【 图 表 】

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