Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.

<h4>Background</h4>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...

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Main Authors: Román Pérez Velasco, Naiyana Praditsitthikorn, Kamonthip Wichmann, Adun Mohara, Surachai Kotirum, Sripen Tantivess, Constanza Vallenas, Hande Harmanci, Yot Teerawattananon
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0030333&type=printable
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author Román Pérez Velasco
Naiyana Praditsitthikorn
Kamonthip Wichmann
Adun Mohara
Surachai Kotirum
Sripen Tantivess
Constanza Vallenas
Hande Harmanci
Yot Teerawattananon
author_facet Román Pérez Velasco
Naiyana Praditsitthikorn
Kamonthip Wichmann
Adun Mohara
Surachai Kotirum
Sripen Tantivess
Constanza Vallenas
Hande Harmanci
Yot Teerawattananon
author_sort Román Pérez Velasco
collection DOAJ
description <h4>Background</h4>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thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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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spelling doaj-art-3e933a5e8536403884b76b8080b243a72025-08-20T02:35:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0172e3033310.1371/journal.pone.0030333Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.Román Pérez VelascoNaiyana PraditsitthikornKamonthip WichmannAdun MoharaSurachai KotirumSripen TantivessConstanza VallenasHande HarmanciYot Teerawattananon<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0030333&type=printable
spellingShingle Román Pérez Velasco
Naiyana Praditsitthikorn
Kamonthip Wichmann
Adun Mohara
Surachai Kotirum
Sripen Tantivess
Constanza Vallenas
Hande Harmanci
Yot Teerawattananon
Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.
PLoS ONE
title Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.
title_full Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.
title_fullStr Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.
title_full_unstemmed Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.
title_short Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.
title_sort systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0030333&type=printable
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