Swine flu pandemic expensive for NZ

A new study estimates the total cost to the New Zealand hospital sector of the 2009 ‘swine flu’ pandemic at around $31 million. The University of Otago, Wellington researchers estimate that given the uncertainties in the data, the range for this cost was $22 to $40 million.

They also report that the true cost of the H1N1 pandemic to the New Zealand health system would be substantially higher as this study looked only at hospitals, and not primary care and public health services.

The lead author, Associate Professor Nick Wilson says: “This influenza pandemic was relatively mild compared to previous ones such as in 1918 which killed over 8500 New Zealanders.”

“But even so the 2009 H1N1 pandemic killed 49 people, sent 1122 people to hospital and 102 were so sick that they needed intensive care unit (ICU) treatment.”

“In the wider community, a 2009 survey using blood samples found that 18% of the population had evidence of infection from the pandemic strain.”

The study reported that the average cost for those going to hospital with pandemic influenza was $17,000 per person with an average stay of six days. For those going to an ICU it was $97,000 per person for an average stay of 12 days.

The study, just published in the New Zealand Medical Journal, also estimated the cost-effectiveness of providing modern hospital care at around $155,000 per life saved from pandemic influenza.

“This is very good value for money, especially since some of the lives saved were young people who would otherwise have lost many years of future life,” says Dr Wilson.

But he noted that this particular estimate was relatively hypothetical given that for mild pandemics hospital care for all who need it is likely to be available in New Zealand. “However, in some future pandemic scenarios hospital services could be overwhelmed and so the death rate could shoot up with people dying at home”.

Another point made by the authors was that a really thorough “full societal costing” study would also include such costs as lower work place productivity and missed time at school because of illness. Premature death in younger adults also removes people from the workforce and so has economic costs.

“Nevertheless, the high cost estimates from just hospital care alone in this study indicate the potential value of further work on preventive measures, such as influenza vaccination, and of investing in pandemic planning and other control measures,” says co-author Associate Professor Michael Baker.

Dr Baker also says that given the sudden and unpredictable nature of such pandemics, there is a strong case for further study of the true costs so as to inform better pandemic planning and preventive measures.

In the same issue of the journal, the University of Otago researchers published a second study analysing the strengths and weaknesses of the health sector response to this pandemic. It found there was evidence for a successful overall response by the public health, primary care and hospital sectors.

Nevertheless, the authors identify a number of likely weaknesses in the response. These include a lack of a detailed review of the overall response and a lack of analytic studies to identify risk factors for hospitalisation and death. There were a lack of studies on pandemic vaccine uptake and public acceptability of this vaccine, and the effectiveness of health protection messages used in mass media campaigns.

“Unfortunately the government didn’t commission any comprehensive review of the response to the 2009 pandemic and the lessons learnt. This is clearly an oversight, given that future pandemics are certain to occur. Governments need to be a bit smarter about doing reviews of disaster response. They should not just commission reviews of disasters where it was obvious that things went badly wrong – like the Pike River Mine,” Dr Wilson says.