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Systematic Review of Economic Evaluations of Preparedness Strategies and Interventions against Influenza Pandemics

Author

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  • Román Pérez Velasco
  • Naiyana Praditsitthikorn
  • Kamonthip Wichmann
  • Adun Mohara
  • Surachai Kotirum
  • Sripen Tantivess
  • Constanza Vallenas
  • Hande Harmanci
  • Yot Teerawattananon

Abstract

Background: Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. Methods: The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. Results: 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita), the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. Conclusion: The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost effectiveness should be readily implemented in forthcoming events that also involve the developing world. Guidelines for assessing the impact of disease and interventions should be drawn up to facilitate these studies.

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  • Román Pérez Velasco & Naiyana Praditsitthikorn & Kamonthip Wichmann & Adun Mohara & Surachai Kotirum & Sripen Tantivess & Constanza Vallenas & Hande Harmanci & Yot Teerawattananon, 2012. "Systematic Review of Economic Evaluations of Preparedness Strategies and Interventions against Influenza Pandemics," PLOS ONE, Public Library of Science, vol. 7(2), pages 1-9, February.
    • Handle: RePEc:plo:pone00:0030333
    DOI: 10.1371/journal.pone.0030333
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    References listed on IDEAS

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    Cited by:

    1. Xinhai Li & Wenjun Geng & Huidong Tian & Dejian Lai, 2013. "Was Mandatory Quarantine Necessary in China for Controlling the 2009 H1N1 Pandemic?," IJERPH, MDPI, vol. 10(10), pages 1-11, September.
    2. Klas Kellerborg & Werner Brouwer & Pieter Baal, 2020. "Costs and benefits of interventions aimed at major infectious disease threats: lessons from the literature," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1329-1350, December.
    3. Itamar Megiddo & Dusan Drabik & Tim Bedford & Alec Morton & Justus Wesseler & Ramanan Laxminarayan, 2019. "Investing in antibiotics to alleviate future catastrophic outcomes: What is the value of having an effective antibiotic to mitigate pandemic influenza?," Health Economics, John Wiley & Sons, Ltd., vol. 28(4), pages 556-571, April.
    4. Peter A.G. van Bergeijk, 2021. "Pandemic Economics," Books, Edward Elgar Publishing, number 20401.
    5. Caroline Orset, 2017. "People's preferences for epidemic prevention measures," Working Papers 2017/01, INRA, Economie Publique.
    6. Patrick Saunders-Hastings & Jane Reisman & Daniel Krewski, 2016. "Assessing the State of Knowledge Regarding the Effectiveness of Interventions to Contain Pandemic Influenza Transmission: A Systematic Review and Narrative Synthesis," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-17, December.
    7. Caroline Orset, 2018. "People’s perception and cost-effectiveness of home confinement during an influenza pandemic: evidence from the French case," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(9), pages 1335-1350, December.
    8. Caroline Orset, 2017. "Effectiveness of confinement to home during an influenza pandemic: evidence from the French case," Working Papers hal-01500902, HAL.

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