Cost-effectiveness of emergency preparedness measures in response to infectious respiratory disease outbreaks: a systematic review and econometric analysis Journal Article
@article{Vardavas2021-do,
title = {Cost-effectiveness of emergency preparedness measures in response to infectious respiratory disease outbreaks: a systematic review and econometric analysis},
author = {Constantine Vardavas and Katerina Nikitara and Konstantinos Zisis and Kostas Athanasakis and Revati Phalkey and Jo Leonardi-Bee and Helen Johnson and Svetla Tsolova and Massimo Ciotti and Jonathan E Suk},
year = {2021},
date = {2021-04-01},
urldate = {2021-04-01},
journal = {BMJ Open},
volume = {11},
number = {4},
pages = {e045113},
abstract = {OBJECTIVES: Respiratory infectious disease outbreaks pose a
threat for loss of life, economic instability and social
disruption. We conducted a systematic review of published
econometric analyses to assess the direct and indirect costs of
infectious respiratory disease outbreaks that occurred between
2003 and 2019. SETTING: Respiratory infectious disease outbreaks
or public health preparedness measures or interventions
responding to respiratory outbreaks in OECD countries (excluding
South Korea and Japan) so as to assess studies relevant to the
European context. The cost-effectiveness of interventions was
assessed through a dominance ranking matrix approach. All cost
data were adjusted to the 2017 Euro, with interventions compared
with the null. We included data from 17 econometric studies.
PRIMARY AND SECONDARY OUTCOME MEASURES: Direct and indirect costs
for disease and preparedness and/or response or cost-benefit and
cost-utility were measured. RESULTS: Overall, the economic burden
of infectious respiratory disease outbreaks was found to be
significant to healthcare systems and society. Indirect costs
were greater than direct costs mainly due to losses of
productivity. With regard to non-pharmaceutical strategies,
prehospitalisation screening and the use of protective masks were
identified as both an effective strategy and cost-saving.
Community contact reduction was effective but had ambiguous
results for cost saving. School closure was an effective measure,
but not cost-saving in the long term. Targeted antiviral
prophylaxis was the most cost-saving and effective pharmaceutical
intervention. CONCLUSIONS: Our cost analysis results provide
evidence to policymakers on the cost-effectiveness of
pharmaceutical and non-pharmaceutical intervention strategies
which may be applied to mitigate or respond to infectious
respiratory disease outbreaks.},
keywords = {health economics; health policy; infection control; infectious diseases; public health},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: Respiratory infectious disease outbreaks pose a
threat for loss of life, economic instability and social
disruption. We conducted a systematic review of published
econometric analyses to assess the direct and indirect costs of
infectious respiratory disease outbreaks that occurred between
2003 and 2019. SETTING: Respiratory infectious disease outbreaks
or public health preparedness measures or interventions
responding to respiratory outbreaks in OECD countries (excluding
South Korea and Japan) so as to assess studies relevant to the
European context. The cost-effectiveness of interventions was
assessed through a dominance ranking matrix approach. All cost
data were adjusted to the 2017 Euro, with interventions compared
with the null. We included data from 17 econometric studies.
PRIMARY AND SECONDARY OUTCOME MEASURES: Direct and indirect costs
for disease and preparedness and/or response or cost-benefit and
cost-utility were measured. RESULTS: Overall, the economic burden
of infectious respiratory disease outbreaks was found to be
significant to healthcare systems and society. Indirect costs
were greater than direct costs mainly due to losses of
productivity. With regard to non-pharmaceutical strategies,
prehospitalisation screening and the use of protective masks were
identified as both an effective strategy and cost-saving.
Community contact reduction was effective but had ambiguous
results for cost saving. School closure was an effective measure,
but not cost-saving in the long term. Targeted antiviral
prophylaxis was the most cost-saving and effective pharmaceutical
intervention. CONCLUSIONS: Our cost analysis results provide
evidence to policymakers on the cost-effectiveness of
pharmaceutical and non-pharmaceutical intervention strategies
which may be applied to mitigate or respond to infectious
respiratory disease outbreaks.