The European Journal of Health Economics

, Volume 11, Issue 6, pp 543–554 | Cite as

The macroeconomic impact of pandemic influenza: estimates from models of the United Kingdom, France, Belgium and The Netherlands

  • Marcus Richard Keogh-BrownEmail author
  • Richard D. Smith
  • John W. Edmunds
  • Philippe Beutels
Original Paper


The 2003 outbreak of severe acute respiratory syndrome (SARS) showed that infectious disease outbreaks can have notable macroeconomic impacts. The current H1N1 and potential H5N1 flu pandemics could have a much greater impact. Using a multi-sector single country computable general equilibrium model of the United Kingdom, France, Belgium and The Netherlands, together with disease scenarios of varying severity, we examine the potential economic cost of a modern pandemic. Policies of school closure, vaccination and antivirals, together with prophylactic absence from work are evaluated and their cost impacts are estimated. Results suggest GDP losses from the disease of approximately 0.5–2% but school closure and prophylactic absenteeism more than triples these effects. Increasing school closures from 4 weeks at the peak to entire pandemic closure almost doubles the economic cost, but antivirals and vaccinations seem worthwhile. Careful planning is therefore important to ensure expensive policies to mitigate the pandemic are effective in minimising illness and deaths.


Macroeconomic modelling Influenza Computable general equilibrium 

JEL Classification




This work was conducted as part of “SARSControl: Effective and acceptable strategies for the control of SARS and new emerging infections in China and Europe”, a European Commission project funded within the Sixth Framework Programme, Thematic Priority Scientific Support to Policies, Contract number: SP22-CT-2004-003824.


  1. 1.
    Keogh-Brown, M.R., Smith, R.D.: The economic impact of SARS: how does the reality match the predictions. Health Policy 88, 110–120 (2008)CrossRefGoogle Scholar
  2. 2.
    Mounier-Jack, S., Coker, R.J.: How prepared is Europe for pandemic influenza? Analysis of national plans. Lancet 367(99520), 1405–1411 (2006)CrossRefGoogle Scholar
  3. 3.
    Beutels, P., Edmunds, W., Smith, R.: Partially wrong? Partial equilibrium and the economic analysis of infectious disease emergencies of international concern. Health Econ. 17(1), 1317–1322 (2008)CrossRefGoogle Scholar
  4. 4.
    Sander, B., Nizam, A., Garrison, L.P., Postma, M.J., Halloran, M.E., Longini, M.S.: Economic evaluation of influenza pandemic mitigation strategies in the United States using a stochastic microsimulation transmission model. Value Health 12(2), 226–233 (2009)CrossRefGoogle Scholar
  5. 5.
    DoH.: Pandemic influenza: a national framework for responding to an influenza pandemic.
  6. 6.
    Woodall, J., Rowse, K.E.K., McDonald, J.C.: Age and Asian influenza. BMJ 29, 1316–1318 (1957)Google Scholar
  7. 7.
    Davis, L.E., Caldwell, G.G., Lynch, R.E., Bailey, R.E., Chin, T.D.Y.: Hong Kong influenza: the epidemiologic features of a high school family study analyzed and compared with a similar study during the 1957 Asian influenza epidemic 1970. Am. J. Epidemiol. 92, 240–247 (1970)Google Scholar
  8. 8.
    Ministry of Health.: Report on the Pandemic of Influenza, 1918–19, London: His Majesty’s Stationery Office (1920)Google Scholar
  9. 9.
    DoH and HPIH & SD.: UK Health Departments’ Influenza Pandemic Contingency Plan.
  10. 10.
    HHS.: HHS Pandemic Influenza Plan, in U.S. Department of Health and Human Services. (2005)
  11. 11.
    HSE and DoH & C.: (2007) National Pandemic Influenza Plan, in Health Services Executive and Department of Health and Children (Ireland). (2007)
  12. 12.
    Public Health Agency of Canada.: The Canadian Pandemic Influenza Plan For The Health Sector.
  13. 13.
    Sadique, M.Z., Edmunds, W.J., Smith, R.D., et al.: Precautionary behavior in response to perceived threat of pandemic influenza. Emerg. Infect. Dis. 13(9), 1307–1313 (2007)Google Scholar
  14. 14.
    Ferguson, N.M., Cummings, D.A.T., Fraser, C., Cajka, J.C., Cooley, P.C., Burke, D.S.: Strategies for mitigating an influenza pandemic. Nature 44(27), 448–452 (2006)CrossRefGoogle Scholar
  15. 15.
    Smith, R., et al.: Assessing the macroeconomic impact of a healthcare problem: the application of computable general equilibrium analysis to antimicrobial resistance. J. Health Econ. 24, 1055–1075 (2005)CrossRefGoogle Scholar
  16. 16.
    McDonald, S., Thierfelder, K., Robinson, S.: Globe: A SAM Based Global CGE Model using GTAP Data, Economics Working Paper. US Naval Academy, Annapolis, MD (2007)Google Scholar
  17. 17.
    Rutten, M., Reed, G.: A comparative analysis of some policy options to reduce rationing in the UK’s NHS: lessons from a general equilibrium model incorporating positive health effects. J. Health Econ. 28(1), 221–233 (2009)CrossRefGoogle Scholar
  18. 18.
    Lofgren, H., Harris, R.L., Robinson, S.: A standard computable general equilibrium (CGE) model in GAMS. Microcomputers in policy research, vol. 5. IFPRI, Washington, DC (2002)Google Scholar
  19. 19.
    Mas-Colell, A., Whinston, M.D., Green, J.R.: Microeconomic theory. Oxford University Press, London (1995)Google Scholar
  20. 20.
    Varian, H.: Microeconomic analysis. Norton, New York (1992)Google Scholar
  21. 21.
    Dimaranan, B.V., McDougall, R.A., Hertel, T.W.: In: Dimaranan, B.V. (ed) Chapter 20. Behavioral parameters, in global trade, assistance, and production: the GTAP 6 database. Center for Global Trade Analysis, Purdue University (2006)Google Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Marcus Richard Keogh-Brown
    • 1
    Email author
  • Richard D. Smith
    • 1
  • John W. Edmunds
    • 2
  • Philippe Beutels
    • 3
  1. 1.Health Policy Unit, Department of Public Health and PolicyLondon School of Hygiene and Tropical MedicineLondonUK
  2. 2.Department of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUK
  3. 3.Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine and Infectious Disease InstituteUniversity of AntwerpAntwerpenBelgium

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