Characteristics of full economic evaluation studies on preparedness and response measures of influenza outbreaks, expressed in Euros (base year 2017)
Study (publication year) | Setting, Year | Population (n) | Interventions | Comparator | Economic evaluation outcomes |
Non-pharmaceutical studies | |||||
Lankelma et al (2019)23 | Netherlands, 2017–2018 | Patients with acute RTI at the emergency department (1546 tests, 624 cases) | Point-of-care-testing for Influenza before hospital admission | 2016–2017 influenza season | Net savings €388 317 (after subtraction with costs) More than 80% of the total savings are due to the shorter length of stay and decreased hospital admissions. The overall cost of intervention: €98 968 Laboratory costs at €72 202 Clinical aspects costs at €26 767 |
Orset (2018)25 | France, 2014 | 200 participants, data extrapolated | 7-day home confinement | No intervention | Costs associated with home confinement (a) Direct costs For adults: €742/case For elderly: €1191/case (b) Indirect costs Productivity losses/case For adults: €550. For elderly: €125 Costs of death/case The cost of death for children is estimated at €22–128, for adults at €63–361 and for elderly at €2667–15 389 Loss of productivity due to influenza/case Productivity loss in case of adult sickness: €88.70 (incl. absent from work+reduced productivity) Productivity loss in case of a sick child for the adult (mainly mother): €97.62 |
Sadique et al (2008)24 | UK, 2005 | Working parents with depending children | School closure | No intervention | Cost of school closure: between €280 million—€2.8 billion/week Cost of absenteeism: €1.4 billion Adjusting for informal care, the cost reduced between €552–€635 million per week. Adjusting for the elasticity of production the cost reduced to €970 327 320—€1.1 billion per week |
Tracht et al (2012)28 | USA, 2009–2010 influenza season | Simulation of the USA (302 million people:73 million children, 191 million adults and 38 million seniors) | Population use of face masks (N95) on the spread of a pandemic | No intervention | Net savings If masks are worn by 10% of the adult population: €418.75 billion If masks are worn by 50% of the adult population: €501.9 billion Economic burden, if no intervention: €728.28 billion (incl. direct and indirect costs) |
Combined pharmaceutical and non-pharmaceutical strategies | |||||
Saunders-Hastings et al (2017)26 | Canada, n/a | A simulation of Ottawa, Canada (1.2 million) |
| No intervention | Cost/LYG vs no intervention
Total economic burden For all scenarios, the economic burden ranges between €75 758 to €1 416 351 |
Halder et al (2011)27 | Australia, 2009 | A community in Western Australia (30 000) | Different combinations of durations of individual school closure, antiviral treatment, household antiviral prophylaxis, extended antiviral prophylaxis, 50% workplace closure, 50% community contact reduction | No intervention | Cost/case averted: Antiviral drug strategies+2 weeks school closure: €396 per case averted (cost-effective) Short-duration school closure: €820/case averted ISC, continuously+50% workplace. continuously: €6 204/case averted In case of 2 weeks for the above combination: €1891/case averted ISC, continuously: €2180/case averted Total cost, per 100 000 population The dual strategy of individual school closure for 2 weeks (ISC) along with the 50% community contact reduction (CCR): €3.39 million The dual strategy of continuous ISC along with the continuous—50% WP: €61.3 million. Productivity loss due to illness and interventions per 100 000 population ISC (cont.)+WP (cont.): €90.21 million Combined antiviral treatment, household antiviral prophylaxis and extended antiviral prophylaxis: €4.63 |
Yarmand et al (2010)29 | USA, 2009–2010 influenza season | North Carolina State University undergraduate students (23 087) | Vaccination | Self-isolation | High levels of interventions Self-isolation is incrementally more cost-effective than vaccination This has been presented for most of cost ratio values. Low levels of interventions Vaccination is incrementally more cost-effective than self-isolation The results were robust, even in sensitivity analyses. |
Sander et al (2009)30 | USA, n/a | Residents of a 1.632-million-person city |
| No intervention | Cost/capita and cost-effectiveness outcomes
ICUR of FTAP: €42 959 ICUR of prevaccination and school closure: €43 106 Cost-saving FTAP and prepandemic vaccination are cost-saving compared with no intervention |
Pharmaceutical only strategies | |||||
Khazeni et al (2009)31 | USA, n/a | A US metropolitan city (8.3 million) |
| No intervention | Intervention and treatment costs
Cost/QALY gained
Expanded adjuvanted vaccination shown to be a cost-effective intervention because it contributes to 404 030 QALYs at $10 844 per QALY gained relative to stockpiled strategy. |
Balicer et al (2005)32 | Israel, n/a | Population of Israel (1 618 200 cases/patients) | Stockpiling with antiviral drugs
| No intervention | CBA Therapeutic use (incl. all and high-risk patients): 2.44–3.68 Pre-exposure (incl. entire and high-risk population): 0.37–0.38 Postexposure: 2.49 Stockpiling with antiviral drugs for high-risk patients remain cost-saving strategy even if the annual probability of a pandemic remains >1 every 80 years. Overall cost The overall health-related costs: €56 234 057 The overall cost to the economy: €535 245 986 Workdays lost due to illness 6 536 240 or 4 days/patient |
Medema et al (2004)33 | n/a, | Developed countries (1 billion people) |
| No intervention | Cost per life-year gained In general, vaccination is cost-effective. Cell culture-based vaccines: €3376/LYG (cost-effective) Cost per intervention Egg-based: €2.6 billion Cell culture-based: €5.87 billion Net savings Egg-based: €8.5 billion Cell culture-based: €5.87 billion Savings: €1.84 billion |
CBA, cost-benefit ratio; CCR, community contact reduction; FTAP, full targeted antiviral prophylaxis; HTAP, household targeted antiviral prophylaxis; ICER, incremental cost-effectiveness ratio; ICUR, incremental cost-utility ratio; ISC, individual school closure; LYG, life-year gained; QALY, quality-adjusted life year; VSL, value of statistical life; WP, workplace closure.