Economic Evaluation of Influenza Pandemic Mitigation Strategies in the United States Using a Stochastic Microsimulation Transmission Model

To project the potential economic impact of pandemic influenza mitigation strategies from a societal perspective in the United States. 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. 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. FTAP is an effective and cost-saving measure for mitigating pandemic influenza.