Background: COVID-19 causes more 1.3 million deaths globally in just nine months.  Influenza is a virus with respiratory symptoms, fever, and systemic symptoms very similar to COVID 19. Various public health measures have been taken by governments and health authorities to prevent and control the pandemics. This study aimed to review the economic evaluation of public health measures against COVID-19 and influenza pandemics.

Methods: We performed a systematic review of the literature to identify full economic evaluation studies on Influenza and COVID-19 pandemic published from 1998-2020. We built an exhaustive database search strategy. The search was done in Pubmed, Web of Science, EMBASE databases, and grey literature. We extracted data from selected studies using a structured data collection form after conducting a risk of bias assessment. Narrative summary tables were used to present the result and characteristics of eligible studies. Furthermore, we converted findings of studies that reported their outcome in costs per case averted and death averted into costs per life-year gained. All cost and Cost-effectiveness ratios were converted to 2019 US dollars using the exchange rate and GDP deflator. The study was registered in PROSPERO with registration No. CRD42020192384.

Results: The review revealed that most of the studies were conducted in high-income countries, and only few of the studies were on non-pharmaceutical interventions. Stockpiling drugs for the treatment of sick patients was found cost-effective in most of the studies. Treatment with antiviral drugs and vaccination were found very cost-effective. The addition of school closure to other interventions was considered cost-effective only for a pandemic with a high case fatality ratio. Almost all interventions were sensitive to the infectivity and severity of the pandemic. Most of the studies were also cost-effective from the societal perspective indicating a higher net societal benefit from the pandemic prevention and control strategies.

Conclusion: In conclusion, most of the interventions were cost-effective under various scenarios while school closure was cost-effective under a 'high case-fatality 'ratio' scenario only. Furthermore, the level of the pandemic's infectivity and severity were the key drivers of the cost-effectiveness of both pharmaceutical and non-pharmaceutical interventions.

Keywords: Pandemic, COVID-19, Influenza, economic evaluation, Prevention and control strategies

Background: COVID-19 causes more 1.3 million deaths globally in just nine months. Influenza is a virus with respiratory symptoms, fever, and systemic symptoms very similar to COVID 19. Various public health measures have been taken by governments and health authorities to prevent and control the pandemics. This study aimed to review the economic evaluation of public health measures against COVID-19 and influenza pandemics.

Methods: We performed a systematic review of the literature to identify full economic evaluation studies on Influenza and COVID-19 pandemic published from 1998-2020. We built an exhaustive database search strategy. The search was done in Pubmed, Web of Science, EMBASE databases, and grey literature. We extracted data from selected studies using a structured data collection form after conducting a risk of bias assessment. Narrative summary tables were used to present the result and characteristics of eligible studies. Furthermore, we converted findings of studies that reported their outcome in costs per case averted and death averted into costs per life-year gained. All cost and Cost-effectiveness ratios were converted to 2019 US dollars using the exchange rate and GDP deflator. The study was registered in PROSPERO with registration No. CRD42020192384.

Results: The review revealed that most of the studies were conducted in high-income countries, and only few of the studies were on non-pharmaceutical interventions. Stockpiling drugs for the treatment of sick patients was found cost-effective in most of the studies. Treatment with antiviral drugs and vaccination were found very cost-effective. The addition of school closure to other interventions was considered cost-effective only for a pandemic with a high case fatality ratio. Almost all interventions were sensitive to the infectivity and severity of the pandemic. Most of the studies were also cost-effective from the societal perspective indicating a higher net societal benefit from the pandemic prevention and control strategies.

Conclusion: In conclusion, most of the interventions were cost-effective under various scenarios while school closure was cost-effective under a 'high case-fatality 'ratio' scenario only. Furthermore, the level of the pandemic's infectivity and severity were the key drivers of the cost-effectiveness of both pharmaceutical and non-pharmaceutical interventions.

Keywords: Pandemic, COVID-19, Influenza, economic evaluation, Prevention and control strategies