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Cost-effectiveness of pharmaceutical-based pandemic influenza mitigation strategies.

Newall AT, Wood JG, Oudin N, MacIntyre CR - Emerging Infect. Dis. (2010)

Bottom Line: In the absence of any intervention, our base-case assumptions generated a population clinical attack rate of 31.1%.Because of the uncertain nature of many parameters, we used a probabilistic approach to determine the most cost-effective strategies.At a willingness to pay of >A$24,000 per life-year saved, more than half the simulations showed that a prepandemic vaccination program combined with antiviral treatment was cost-effective in Australia.

View Article: PubMed Central - PubMed

Affiliation: University of New South Wales, Sydney, New South Wales, Australia.

ABSTRACT
We used a hybrid transmission and economic model to evaluate the relative merits of stockpiling antiviral drugs and vaccine for pandemic influenza mitigation. In the absence of any intervention, our base-case assumptions generated a population clinical attack rate of 31.1%. For at least some parameter values, population prepandemic vaccination strategies were effective at containing an outbreak of pandemic influenza until the arrival of a matched vaccine. Because of the uncertain nature of many parameters, we used a probabilistic approach to determine the most cost-effective strategies. At a willingness to pay of >A$24,000 per life-year saved, more than half the simulations showed that a prepandemic vaccination program combined with antiviral treatment was cost-effective in Australia.

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Related in: MedlinePlus

Schematic of hybrid transmission and decision analytic economic model. [+] indicates a cloned subtree with the same structure as the branch above. In sensitivity analysis, the probabilities of healthcare utilization and death were independent of each other but dependent on the probability of clinical infection. We assumed those with serious complications would seek primary healthcare. SEIR, susceptible, exposed, infected, removed.
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Figure 1: Schematic of hybrid transmission and decision analytic economic model. [+] indicates a cloned subtree with the same structure as the branch above. In sensitivity analysis, the probabilities of healthcare utilization and death were independent of each other but dependent on the probability of clinical infection. We assumed those with serious complications would seek primary healthcare. SEIR, susceptible, exposed, infected, removed.

Mentions: An age-stratified transmission model (susceptible, exposed, infected, removed) was used to calculate clinical attack rates (CAR) and antiviral drug consumption, which became inputs in a decision analytic economic model as represented in Figure 1 (MATLAB version 2008a [www.mathworks.com]). The primary outcome from the economic model was the incremental cost per life-year saved (LYS). Economic results are reported per person in the population to facilitate understanding for an international audience. We addressed the uncertainty in many of the model parameters by performing extensive sensitivity analyses, including probabilistic sensitivity analysis using 5,000 Latin hypercube samples drawn from parameter distributions. A detailed description of the transmission model and a full list of model parameters and distributions can be found in the appendices (Technical Appendix 1, and Technical Appendix 2).


Cost-effectiveness of pharmaceutical-based pandemic influenza mitigation strategies.

Newall AT, Wood JG, Oudin N, MacIntyre CR - Emerging Infect. Dis. (2010)

Schematic of hybrid transmission and decision analytic economic model. [+] indicates a cloned subtree with the same structure as the branch above. In sensitivity analysis, the probabilities of healthcare utilization and death were independent of each other but dependent on the probability of clinical infection. We assumed those with serious complications would seek primary healthcare. SEIR, susceptible, exposed, infected, removed.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2957998&req=5

Figure 1: Schematic of hybrid transmission and decision analytic economic model. [+] indicates a cloned subtree with the same structure as the branch above. In sensitivity analysis, the probabilities of healthcare utilization and death were independent of each other but dependent on the probability of clinical infection. We assumed those with serious complications would seek primary healthcare. SEIR, susceptible, exposed, infected, removed.
Mentions: An age-stratified transmission model (susceptible, exposed, infected, removed) was used to calculate clinical attack rates (CAR) and antiviral drug consumption, which became inputs in a decision analytic economic model as represented in Figure 1 (MATLAB version 2008a [www.mathworks.com]). The primary outcome from the economic model was the incremental cost per life-year saved (LYS). Economic results are reported per person in the population to facilitate understanding for an international audience. We addressed the uncertainty in many of the model parameters by performing extensive sensitivity analyses, including probabilistic sensitivity analysis using 5,000 Latin hypercube samples drawn from parameter distributions. A detailed description of the transmission model and a full list of model parameters and distributions can be found in the appendices (Technical Appendix 1, and Technical Appendix 2).

Bottom Line: In the absence of any intervention, our base-case assumptions generated a population clinical attack rate of 31.1%.Because of the uncertain nature of many parameters, we used a probabilistic approach to determine the most cost-effective strategies.At a willingness to pay of >A$24,000 per life-year saved, more than half the simulations showed that a prepandemic vaccination program combined with antiviral treatment was cost-effective in Australia.

View Article: PubMed Central - PubMed

Affiliation: University of New South Wales, Sydney, New South Wales, Australia.

ABSTRACT
We used a hybrid transmission and economic model to evaluate the relative merits of stockpiling antiviral drugs and vaccine for pandemic influenza mitigation. In the absence of any intervention, our base-case assumptions generated a population clinical attack rate of 31.1%. For at least some parameter values, population prepandemic vaccination strategies were effective at containing an outbreak of pandemic influenza until the arrival of a matched vaccine. Because of the uncertain nature of many parameters, we used a probabilistic approach to determine the most cost-effective strategies. At a willingness to pay of >A$24,000 per life-year saved, more than half the simulations showed that a prepandemic vaccination program combined with antiviral treatment was cost-effective in Australia.

Show MeSH
Related in: MedlinePlus