Vardavas Constantine, Nikitara Katerina, Zisis Konstantinos, Athanasakis Konstantinos, Phalkey Revati, Leonardi-Bee Jo, Johnson Helen, Tsolova Svetla, Ciotti Massimo, Suk Jonathan E
School of Medicine, University of Crete, Heraklion, Greece.
Department of Public Health Policy, School of Public Health, University of West Attica, Egaleo, Greece.
BMJ Open. 2021 Apr 29;11(4):e045113. doi: 10.1136/bmjopen-2020-045113.
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.
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.
Direct and indirect costs for disease and preparedness and/or response or cost-benefit and cost-utility were measured.
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.
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.
呼吸道传染病暴发对生命损失、经济不稳定和社会混乱构成威胁。我们对已发表的计量经济学分析进行了系统综述，以评估2003年至2019年间发生的传染性呼吸道疾病暴发的直接和间接成本。
经合组织国家（不包括韩国和日本）的呼吸道传染病暴发或应对呼吸道暴发的公共卫生防范措施或干预措施，以便评估与欧洲背景相关的研究。通过优势排序矩阵方法评估干预措施的成本效益。所有成本数据均调整为2017年欧元，将干预措施与无干预情况进行比较。我们纳入了17项计量经济学研究的数据。
测量疾病、防范和/或应对的直接和间接成本，或成本效益和成本效用。
总体而言，传染性呼吸道疾病暴发的经济负担对医疗系统和社会来说是巨大的。间接成本大于直接成本，主要是由于生产力损失。关于非药物策略，住院前筛查和使用防护口罩被确定为既有效又节省成本的策略。减少社区接触是有效的，但在节省成本方面结果不明确。学校关闭是一项有效措施，但从长期来看并不节省成本。有针对性的抗病毒预防是最节省成本且有效的药物干预措施。
我们的成本分析结果为政策制定者提供了证据，证明了可用于减轻或应对传染性呼吸道疾病暴发的药物和非药物干预策略的成本效益。
