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


CONCLUSIONS
FTAP is an effective and cost-saving measure for mitigating pandemic influenza.
Sander
Beate
B
Department of Health Policy, Management and Evaluation, University of Toronto, Canada. bsander@uhnres.utoronto.ca
Nizam
Azhar
A
Garrison
Louis P
LP
Postma
Maarten J
MJ
Halloran
M Elizabeth
ME
Longini
Ira M
IM
D000998:Antiviral Agents / Q000191:economics / Q000627:therapeutic use; D003198:Computer Simulation; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004196:Disease Outbreaks / Q000191:economics / Q000517:prevention & control; D006801:Humans; D007251:Influenza, Human / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D008954:Models, Biological; D018803:Models, Economic; D011634:Public Health / Q000191:economics* / Q000379:methods; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013269:Stochastic Processes; D014481:United States / Q000453:epidemiology
D000998:Antiviral Agents