Economics of neuraminidase inhibitor stock piling for pandemic influenza, Singapore.
We compared strategies for stock piling neuraminidase inhibitors to treat and prevent influenza in Singapore. Cost-benefit and cost-effectiveness analyses, with Monte Carlo simulations, were used to determine economic outcomes. A pandemic in a population of 4.2 million would result in an estimated 525-1,775 deaths, 10,700-38,600 hospitalization days, and economic costs of 0.7 dollars to 2.2 billion Singapore dollars. The treatment-only strategy had optimal economic benefits: stock piles of antiviral agents for 40% of the population would save an estimated 418 lives and 414 million dollars, at a cost of 52.6 million dollars per shelf-life cycle of the stock pile. Prophylaxis was economically beneficial in high-risk subpopulations, which account for 78% of deaths, and in pandemics in which the death rate was >0.6%. Prophylaxis for pandemics with a 5% case-fatality rate would save 50,000 lives and 81 billion dollars. These models can help policymakers weigh the options for pandemic planning.
Tan Tock Seng Hospital, Singapore. vernonljm@hotmail.com
Vernon J
VJ
Lee
Kai Hong
KH
Phua
Mark I
MI
Chenm
Angela
A
Chow
Stefan
S
Ma
Kee Tai
KT
Goh
Yee Sin
YS
Leo
D000998:Antiviral Agents / Q000191:economics* / Q000600:supply & distribution* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003657:Decision Making; D004196:Disease Outbreaks / Q000517:prevention & control; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D009439:Neuraminidase / Q000037:antagonists & inhibitors*; D012846:Singapore / Q000453:epidemiology; D015996:Survival Rate
D000998:Antiviral Agents; D009439:Neuraminidase