Economics of Neuraminidase Inhibitor Stockpiling for Pandemic Influenza, Singapore

Lee, Vernon J.; Phua, Kai Hong; Chen, Mark; Chow, Angela; Ma, Stefan; Goh, Kee Tai; Leo, Yee Sin

doi:10.3201/eid1201.050556

Cited by 43 publications

(26 citation statements)

References 27 publications

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“…For pandemic duration, there is only one study using data from a previous economic evaluation of antiviral stockpiling in Singapore, which estimates pandemic duration at 12 weeks 4. In six studies that estimate pandemic duration from expert opinion, the value varies from 15 to 43 weeks.…”

Section: Resultsmentioning

confidence: 99%

Assessing key model parameters for economic evaluation of pandemic influenza interventions: the data source matters

Praditsitthikorn

Kotirum

Mohara

et al. 2013

Influenza Resp Viruses

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BackgroundIn our previous systematic review of economic evaluations of pandemic influenza interventions, five model parameters, namely probability of pandemic, duration of pandemic, severity, attack rate, and intervention efficacy, were not only consistently used in all studies but also considered important by authors.ObjectivesBecause these parameters originated from sources of varying quality ranging from experimental studies to expert opinion, this study aims to analyze the variation in values used according to sources of information across studies.MethodsAn analysis of estimated values of key parameters for economic modeling was performed against their different data sources, following the standard hierarchy of evidence.ResultsA lack of good‐quality evidence to estimate pandemic duration, pandemic probability, and mortality reduction from antiviral treatment results in a large variation of values used in economic evaluations. Although there are variations in quality of evidence used for attack rate, basic reproduction number, and reduction in hospitalizations from antiviral treatment, the estimated values do not vary significantly. The use of higher‐quality evidence results in better precision of estimated values compared to lower‐quality sources.ConclusionHierarchies of evidence are a necessary tool to identify appropriate model parameters to populate economic evaluations and should be included in methodological guidelines. Knowledge gaps in some key parameters should be addressed, because if good‐quality evidence is available, future economic evaluations will be more reliable. Some gaps may not be fulfilled by research but consensus among experts to ensure consistency in the use of these assumptions.

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Section: Resultsmentioning

confidence: 99%

Assessing key model parameters for economic evaluation of pandemic influenza interventions: the data source matters

Praditsitthikorn

Kotirum

Mohara

et al. 2013

Influenza Resp Viruses

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show abstract

“…Simulated studies of the evolution of the pandemic in various scenarios [5][6][7] and studies of the efficiency of various interventions [8] are essential to prioritize the most effective and efficient options and especially to prepare plans for application at times of great medical demand accompanied by media pressure: under these circumstances, it is not easy to generate correct protocols. Therefore plans of actuation should be followed without major deviations.…”

Section: Usefulness Of Simulated Cases For Assessing Pandemic Influenmentioning

confidence: 99%

Usefulness of simulated cases for assessing pandemic influenza preparedness plans

Cardeñosa

Domı́nguez

Carratalà

et al. 2010

Clinical Microbiology and Infection

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To evaluate compliance with preparedness plans, actors simulating avian influenza attended various hospital emergency departments and public health centres during the last quarter of 2007. Most centres (89%) did not respond correctly. The useful information obtained was sent to the medical and administrative staff who were responsible for the preparedness plans. Awareness of these errors and their rectification can lead to improvements in the response to any case of influenza with pandemic potential and in the capacity to combat any other emergent or re-emergent community infection.

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“…In the Vaccine Model, the normal influenza season is modeled using a 20% attack rate (MELTZER, 1999;LEE, 2006;GERDIL, 2003;CBO, 2005). The attack rate multiplied by the percentage of each population death rate if attacked gives the fraction of each age group that dies of the influenza virus.…”

Section: Influenza Virus Attack and Death Ratesmentioning

confidence: 99%

A Model for the Ordering and Distribution of the Influenza Vaccine

Gurr

2011

2011 44th Hawaii International Conference on System Sciences

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and ABSTRACT (maximum 200 words)The system for the production and distribution of the United States supply of influenza vaccine has experienced disruptions during past influenza seasons. The identification of elements of the influenza vaccine is different each year and must be researched and identified each year prior to the influenza season. The manufacturing of the vaccine is a complicated process with many potential problems. This thesis identifies the requirements and constraints of the current manufacturing and distribution system including the annual demand and supply. This information is used to create an illustrative model based on operational research and operational management theory to develop a systematic approach to distribution of the influenza vaccine in a shortage situation. Two different policies are identified for use in a normal influenza season to determine how many companies are required to provide a sufficient amount of influenza vaccine with the understanding that some of the companies might have manufacturing difficulties. These two policies are the percentage distribution policy and the strict priority distribution policy. The model includes a determination of the number of companies that should be available for influenza vaccine production and the amount of vaccine that should be ordered from each company to minimize the total cost. The majority of the influenza seasons could be covered by purchasing fewer than 108 million doses, as in the percentage distribution policy, making sure that the vaccine dose orders are spread out evenly over four companies and distributed evenly by age group percentage, but could be reduced to as little as 24.5 million total vaccine doses if necessary with minimal cost and loss of life using a strict priority distribution policy. Submitted in partial fulfillment of the requirements for the degree of NUMBER OF PAGES 69 SUBJECT TERMS MASTER OF SCIENCE IN SYSTEMS ENGINEERINGfrom the NAVAL POSTGRADUATE SCHOOL June 2006Author: James Richard Gurr

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Economics of Neuraminidase Inhibitor Stockpiling for Pandemic Influenza, Singapore

Abstract: Stockpiling drugs to prevent and treat influenza would be economically effective.

Cited by 43 publications

References 27 publications

Assessing key model parameters for economic evaluation of pandemic influenza interventions: the data source matters

Assessing key model parameters for economic evaluation of pandemic influenza interventions: the data source matters

Usefulness of simulated cases for assessing pandemic influenza preparedness plans

A Model for the Ordering and Distribution of the Influenza Vaccine

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