Economic Burden of Influenza in Thailand: A Systematic Review

Thailand has a high incidence and high mortality rates of influenza. This study summarizes the evidence on economic burden or costs of influenza subsequent to the occurrence of influenza illness in the Thai population by specific characteristics such as population demographics, health conditions, healthcare facilities, and/or cost types from published literature. A systematic search was conducted in six electronic databases. All costs were extracted and adjusted to 2018 US dollar value. Out of 581 records, 11 articles (1 with macroeconomic analysis and 10 with microeconomic analyses) were included. Direct medical costs per episode for outpatients and inpatients ranged from US$4.21 to US$212.17 and from US$163.62 to US$4577.83, respectively, across distinct influenza illnesses. The overall burden of influenza was between US$31.1 and US$83.6 million per year and 50-53% of these estimates referred to lost productivity. Costs of screening for an outbreak of influenza at an 8-bed-intensive-care-unit hospital was US$38242.75 per year. Labor-sensitive sectors such as services were the most affected part of the Thai economy. High economic burden tended to occur among children and older adults with co-morbidities and to be related to complications, non-vaccinated status, and severe influenza illness. Strategies involving prevention, limit of transmission, and treatment focusing on aforementioned patients' factors, containment of hospitalization expenses and quarantine process, and assistance on labor-sensitive economy sectors are likely to reduce the economic burden of influenza. However, a research gap exists regarding knowledge about the economic burden of influenza in Thailand.