Economic evaluation of influenza pandemic mitigation strategies in the United States using a stochastic microsimulation transmission model

Value Health. Mar-Apr 2009;12(2):226-33. doi: 10.1111/j.1524-4733.2008.00437.x. Epub 2008 Jul 30.


Objectives: To project the potential economic impact of pandemic influenza mitigation strategies from a societal perspective in the United States.

Methods: We use a stochastic agent-based model to simulate pandemic influenza in the community. We compare 17 strategies: targeted antiviral prophylaxis (TAP) alone and in combination with school closure as well as prevaccination.

Results: In the absence of intervention, we predict a 50% attack rate with an economic impact of $187 per capita as loss to society. Full TAP (FTAP) is the most effective single strategy, reducing number of cases by 54% at the lowest cost to society ($127 per capita). Prevaccination reduces number of cases by 48% and is the second least costly alternative ($140 per capita). Adding school closure to FTAP or prevaccination further improves health outcomes but increases total cost to society by approximately $2700 per capita.

Conclusion: FTAP is an effective and cost-saving measure for mitigating pandemic influenza.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antiviral Agents / economics
  • Antiviral Agents / therapeutic use
  • Computer Simulation*
  • Cost Savings
  • Cost-Benefit Analysis
  • Disease Outbreaks* / economics
  • Disease Outbreaks* / prevention & control
  • Humans
  • Influenza, Human / economics*
  • Influenza, Human / epidemiology
  • Influenza, Human / prevention & control
  • Models, Biological
  • Models, Economic
  • Public Health / economics*
  • Public Health / methods
  • Quality of Life
  • Quality-Adjusted Life Years
  • Stochastic Processes*
  • United States / epidemiology


  • Antiviral Agents