Epidemiology and Infection

Original Papers


Cost-effectiveness of influenza control measures: a dynamic transmission model-based analysis

S.-C. CHENa1a2 c1 and C.-M. LIAOa3

a1 Department of Public Health, Chung Shan Medical University, Taichung, Taiwan, ROC

a2 Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC

a3 Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan, ROC


We investigated the cost-effectiveness of different influenza control strategies in a school setting in Taiwan. A susceptible-exposure-infected-recovery (SEIR) model was used to simulate influenza transmission and we used a basic reproduction number (R 0)–asymptomatic proportion (θ) control scheme to develop a cost-effectiveness model. Based on our dynamic transmission model and economic evaluation, this study indicated that the optimal cost-effective strategy for all modelling scenarios was a combination of natural ventilation and respiratory masking. The estimated costs were US$10/year per person in winter for one kindergarten student. The cost for hand washing was estimated to be US$32/year per person, which was much lower than that of isolation (US$55/year per person) and vaccination (US$86/year per person) in containing seasonal influenza. Transmission model-based, cost-effectiveness analysis can be a useful tool for providing insight into the impacts of economic factors and health benefits on certain strategies for controlling seasonal influenza.

(Received July 30 2012)

(Revised December 12 2012)

(Accepted February 06 2013)

(Online publication March 12 2013)

Key words

  • Cost-effectiveness analysis;
  • influenza;
  • modelling;
  • control measures;
  • basic reproduction number


c1 Author for correspondence: Dr S.-C. Chen, Department of Public Health, Chung Shan Medical University, Taichung, Taiwan 40201, ROC. (Email: scchen@csmu.edu.tw)