Research

Modeling the economic impact of pandemic influenza in the United States: Implications for setting priorities for intervention

Martin I. Meltzer, Ph.D., Nancy J. Cox, Ph.D., Keiji Fukuda, MD

Back to background paper Figure 1: Frequency of outpatient visits per patient for influenza, pneumonia and acute bronchitis: 1993-95 Note: ICD-9 codes used to define conditions and extract data are given in Table 4. N= 689,866 individual patients identified. Source: MarketScan database, MEDSTAT Group.

Back to background paper Figure 2: Impact of influenza pandemic in the United States: Mean, minimum, maximum, 5th and 95th percentiles of total deaths and hospitalizations for different gross attack rates Notes: A) age distributions of cases given in Table 2. B) For each gross attack rates, data are totals for all age groups and risk categories.

Back to background paper Figure 3: Impact of influenza pandemic in the United States: Mean, minimum, and maximum of total outpatients and those ill (but not seeking formal medical care) for different gross attack rates Note: For each gross attack rates, data are totals for all age groups and risk categories.

Back to background paper Figure 4: Sensitivity analysis: Mean net returns to vaccination, by age group, for different death rates, vaccine effectiveness, and percentage compliance: Non-high risk patients Notes: 1) Initial mean death rates (proportion = 1.00) used for non-high risk patients were: 0-19 years 0.055/ 1,000 general population: 20-64 years 0.051/ 1,000 general population; 65 + years 0.413/ 1,000 general population (see Table 3). Other death rates used were proportions of these rates (0.25 and 0.50). 2) Values defining vaccine effectiveness ("high" and "low") are given in Table 13. 3) Scenario A of age-distribution of cases was used (Table 2).

Back to background paper Figure 5: Four options to respond to an influenza pandemic: Mean net economic returns Notes: 1) Bars show mean net returns for each option and assumed cost of vaccination. 2) Option A: Similar to current Advisory Committee on Immunization Practices (ACIP) recommendations, with production and use similar to current, intra-pandemic recommendations.2 Assumed approximately 77 million vaccinees. Option B: Number of vaccinees as outlined in Scenario A plus an additional 20 million essential service providers (5 million health care workers + 15 million other service providers). Option C: Aim to achieve a 40 percent coverage in each age and risk group. Option D: Aim to achieve 60 percent coverage in each age and risk group. See Table 14 for further details.