Influenza pandemic planning in Switzerland—an economic perspective

Abstract

An economic evaluation of several intervention strategies was conducted to contribute to the setting-up of the national influenza pandemic preparedness planning in Switzerland. A decision analysis model was developed to analyze the strategies for different Swiss population subgroups. Local treatment patterns, medical resources use and costs and other necessary data were obtained from national statistics, the literature and expert opinions. Analyses were undertaken from a public health and a societal perspective. The intervention strategies based on availability of vaccine and antiviral medication included the prophylaxis of health care workers (HCW) with antivirals; vaccination of HCW, elderly, high-risk elderly and high-risk adults; post-infection treatment of HCW and adults with antivirals. A worst-case scenario, based on the 1918–1919 influenza pandemic, was chosen as a basis for epidemiological and economic data. To date, in Switzerland, an influenza pandemic could result in 42,000 excess deaths and societal costs of CHF 2.5 billion. The key conclusions of the study were that any prevention strategy must give priority to HCW, essentially to keep the health care system fully functional. Following the availability of a pandemic vaccine, vaccination must be done as soon as possible targeting HCW first; from a public health perspective, vaccination of high-risk groups and elderly was cost-effective; from a societal perspective, vaccination of all adults of working age was cost saving. Post-infection treatment of adults was cost saving from a societal perspective.