Decision making with regard to antiviral intervention during an influenza pandemic.

Medical Decision Making : an International Journal of the Society for Medical Decision Making
Eunha ShimAlison P Galvani

Abstract

Antiviral coverage is defined by the proportion of the population that takes antiviral prophylaxis or treatment. High coverage of an antiviral drug has epidemiological and evolutionary repercussions. Antivirals select for drug resistance within the population, and individuals may experience adverse effects. To determine optimal antiviral coverage in the context of an influenza outbreak, we compared 2 perspectives: 1) the individual level (the Nash perspective), and 2) the population level (utilitarian perspective). We developed an epidemiological game-theoretic model of an influenza pandemic. The data sources were published literature and a national survey. The target population was the US population. The time horizon was 6 months. The perspective was individuals and the population overall. The interventions were antiviral prophylaxis and treatment. The outcome measures were the optimal coverage of antivirals in an influenza pandemic. At current antiviral pricing, the optimal Nash strategy is 0% coverage for prophylaxis and 30% coverage for treatment, whereas the optimal utilitarian strategy is 19% coverage for prophylaxis and 100% coverage for treatment. Subsidizing prophylaxis by $440 and treatment by $85 would bring the Nash...Continue Reading

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Citations

Apr 13, 2012·Journal of the Royal Society, Interface·Eunha ShimAlison P Galvani
Mar 5, 2011·BMC Public Health·Eunha ShimAlison P Galvani
Dec 14, 2012·PloS One·Travis C PorcoThomas M Lietman
Mar 3, 2011·Mathematical Biosciences and Engineering : MBE·Eunha Shim
Jul 2, 2014·Computational and Mathematical Methods in Medicine·Nicolas Sippl-SwezeyTravis C Porco
Jul 31, 2010·Journal of Theoretical Biology·Benjamin R MorinCarlos Castillo-Chavez
Nov 24, 2011·Journal of Theoretical Biology·Eunha ShimDonald S Burke
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Jun 14, 2017·Mathematical Biosciences and Engineering : MBE·Wisdom S AvusugloWenying Feng
Apr 25, 2019·BMC Medicine·Anna Maria NiewiadomskaCecile Viboud
Nov 5, 2015·Journal of Biological Dynamics·Junyuan YangYuming Chen
Jan 1, 2015·Frontiers of Computer Science·Wei DuanXiaogang Qiu

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