Strategies for antiviral stockpiling for future influenza pandemics: a global epidemic-economic perspective
Strategies for antiviral stockpiling for future influenza pandemics: a global epidemic-economic perspective
复制标题
DOI：
10.1098/rsif.2010.0715
复制
发表时间：
2011-09-07
影响因子：
3.9
通讯作者：
Cook, Alex R.
中科院分区：
文献类型：
--
作者：
Carrasco, Luis R.;Lee, Vernon J.;Cook, Alex R.
流感大流行由于其潜在的死亡率和巨大的经济影响而构成全球威胁。储存抗病毒药物以控制大流行是抵消其负面影响的有效策略;然而，人们对不确定性下的长期最佳库存规模以及不同国家的特点知之甚少。我们使用一个卫生经济模型研究了巴西、中国、危地马拉、印度、印度尼西亚、新西兰、新加坡、英国、美国和津巴布韦的抗病毒药物储备量对总死亡率和成本的影响。在该模型中，抗病毒药物的储备大大降低了死亡率。在资源较多的国家（例如，G.从550亿美元到270亿美元，超过30年的时间跨度为美国）和大量避免死亡，在那些资源不足（e。G.从1140万到230万）。在完美分配的情况下，资源较多的国家应致力于储存能够覆盖至少15%人口的抗病毒药物储备，在30%分配不当的情况下，这一比例应升至25%，以尽量减少死亡和经济成本。根据目前的抗病毒药物价格，估计对世界三分之二的人口来说，储存抗病毒药物不具有成本效益。降低价格和开展国际合作是使抗病毒药物在资源有限的国家具有成本效益的拯救生命潜力所必需的。
Influenza pandemics present a global threat owing to their potential mortality and substantial economic impacts. Stockpiling antiviral drugs to manage a pandemic is an effective strategy to offset their negative impacts; however, little is known about the long-term optimal size of the stockpile under uncertainty and the characteristics of different countries. Using an epidemic-economic model we studied the effect on total mortality and costs of antiviral stockpile sizes for Brazil, China, Guatemala, India, Indonesia, New Zealand, Singapore, the UK, the USA and Zimbabwe. In the model, antivirals stockpiling considerably reduced mortality. There was greater potential avoidance of expected costs in the higher resourced countries (e. g. from $55 billion to $27 billion over a 30 year time horizon for the USA) and large avoidance of fatalities in those less resourced (e. g. from 11.4 to 2.3 million in Indonesia). Under perfect allocation, higher resourced countries should aim to store antiviral stockpiles able to cover at least 15 per cent of their population, rising to 25 per cent with 30 per cent misallocation, to minimize fatalities and economic costs. Stockpiling is estimated not to be cost-effective for two-thirds of the world's population under current antivirals pricing. Lower prices and international cooperation are necessary to make the life-saving potential of antivirals cost-effective in resource-limited countries.