Economic evaluation of influenza pandemic mitigation strategies in the United States using a stochastic microsimulation transmission model

• Type of Material: Article
• Authors: Beate Sander, University of Toronto; Azhar Nizam, Emory University; Louis P. Garrison, Jr., University of Washington; Maarten J. Postma, University of Groningen; M. Elizabeth Halloran, University of Washington; Ira M. Longini, Jr., University of Washington
• Language: English
• Date: 2009-01-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2008, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1111/j.1524-4733.2008.00437.x
• Title of Journal or Parent Work: Value in Health
• ISSN: 1098-3015
• Volume: 12
• Issue: 2
• Start Page: 226
• End Page: 233
• Grant/Funding Information: Beate Sander, Azhar Nizam, Louis P. Garrison Jr., Maarten J Postma, M. Elizabeth Halloran, and Ira M. Longini Jr. received a consultancy fee from F. Hoffmann-La Roche, Ltd, Basel, Switzerland.; This work was partially supported by the National Institute of General Medical Sciences MIDAS grant U01-GM070749.
• Keywords: Humans; Models, Economic; Models, Biological; Quality of Life; Cost Savings; Computer Simulation; Influenza, Human; Public Health; Disease Outbreaks; United States; Quality-Adjusted Life Years; Antiviral Agents; Cost-Benefit Analysis; Stochastic Processes
• Research Categories: Biology, Virology; Biology, Biostatistics

Abstract

Objectives: To project the potential economic impact of pandemic influenza mitigation strategies from a societal perspective in the United States. Methods: We use a stochastic agent-based model to simulate pandemic influenza in the community. We compare 17 strategies: targeted antiviral prophylaxis (TAP) alone and in combination with school closure as well as prevaccination. Results: In the absence of intervention, we predict a 50% attack rate with an economic impact of $187 per capita as loss to society. Full TAP (FTAP) is the most effective single strategy, reducing number of cases by 54% at the lowest cost to society ($127 per capita). Prevaccination reduces number of cases by 48% and is the second least costly alternative ($140 per capita). Adding school closure to FTAP or prevaccination further improves health outcomes but increases total cost to society by approximately $2700 per capita. Conclusion: FTAP is an effective and cost-saving measure for mitigating pandemic influenza.