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Eur J Public Health. 2019 May 5. pii: ckz074. doi: 10.1093/eurpub/ckz074. [Epub ahead of print]

Cost-effectiveness of public health interventions against human influenza pandemics in France: a methodological contribution from the FLURESP European Commission project.

Author information

1
Data Mining International, Geneva, Switzerland.
2
Paris-Descartes University, Paris, France.
3
Istitut Superiore di Sanita, Rome, Italy.
4
Queen Mary College, London, UK.
5
National Institute of Public Health, Warsaw, Poland.
6
National Institute of Public Health, Bucharest, Romania.
7
Basque Institute for Agricultural Research and Development, Derio, Spain.
8
Niddam European Community Lawyer, Budapest, Hungary.
9
Claude-Bernard University, Lyon, France.
10
School of Medicine University of Crete, Crete, Greece.
11
Ministry of Health, St Valletta, Malta.
12
CNRS FR3636, ParisV René Descartes University, Paris, France.
13
CLAIROP n°48 Clinical Trial Center, University Hospital Necker-Enfants Malades, APHP, Paris, France.

Abstract

BACKGROUND:

The FLURESP project is a public health project funded by the European Commission with the objective to design a methodological approach in order to compare the cost-effectiveness of existing public health measures against human influenza pandemics in four target countries: France, Italy, Poland and Romania. This article presents the results relevant to the French health system using a data set specifically collected for this purpose.

METHODS:

Eighteen public health interventions against human influenza pandemics were selected. Additionally, two public-health criteria were considered: 'achieving mortality reduction ≥40%' and 'achieving morbidity reduction ≥30%'. Costs and effectiveness data sources include existing reports, publications and expert opinions. Cost distributions were taken into account using a uniform distribution, according to the French health system.

RESULTS:

Using reduction of mortality as an effectiveness criterion, the most cost-effective options was 'implementation of new equipment of Extracorporeal membrane oxygenation (ECMO) equipment'. Targeting vaccination to health professionals appeared more cost-effective than vaccination programs targeting at risk populations. Concerning antiviral distribution programs, curative programs appeared more cost-effective than preventive programs. Using reduction of morbidity as effectiveness criterion, the most cost-effective option was 'implementation of new equipment ECMO'. Vaccination programs targeting the general population appeared more cost-effective than both vaccination programs of health professionals or at-risk populations. Curative antiviral programs appeared more cost-effective than preventive distribution programs, whatever the pandemic scenario.

CONCLUSION:

Intervention strategies against human influenza pandemics impose a substantial economic burden, suggesting a need to develop public-health cost-effectiveness assessments across countries.

PMID:
31056657
DOI:
10.1093/eurpub/ckz074

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