title: Cost-effective strategies for mitigating a future influenza pandemic with H1N1 2009 characteristics.
abstract: BACKGROUND
  We performed an analysis of the cost-effectiveness of pandemic intervention strategies using a detailed, individual-based simulation model of a community in Australia together with health outcome data of infected individuals gathered during 2009-2010. The aim was to examine the cost-effectiveness of a range of interventions to determine the most cost-effective strategies suitable for a future pandemic with H1N1 2009 characteristics.
  
  
  RESULTS
  Using transmissibility, age-stratified attack rates and health outcomes determined from H1N1 2009 data, we determined that the most cost-effective strategies involved treatment and household prophylaxis using antiviral drugs combined with limited duration school closure, with costs ranging from $632 to $777 per case prevented. When school closure was used as a sole intervention we found the use of limited duration school closure to be significantly more cost-effective compared to continuous school closure, a result with applicability to countries with limited access to antiviral drugs. Other social distancing strategies, such as reduced workplace attendance, were found to be costly due to productivity losses.
  
  
  CONCLUSIONS
  The mild severity (low hospitalisation and case fatality rates) and low transmissibility of H1N1 2009 meant that health treatment costs were dominated by the higher productivity losses arising from workplace absence due to illness and childcare requirements following school closure. Further analysis for higher transmissibility but with the same, mild severity had no effect on the overall findings.
authors.affiliation: School of Computer Science and Software Engineering, University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Nilimesh
authors.initials: N
authors.lastname: Halder
authors.forename: Joel K
authors.initials: JK
authors.lastname: Kelso
authors.forename: George J
authors.initials: GJ
authors.lastname: Milne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000502:physiology*; D007251:Influenza, Human / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology* / Q000821:virology; D008875:Middle Aged; D058873:Pandemics / Q000191:economics* / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000998:Antiviral Agents