Journal Article

Cost-effectiveness analysis of N95 respirators and medical masks to protect healthcare workers in China from respiratory infections

Seale, Holly, Yang, Peng, Wang, Quanyi, MacIntyre, C. Raina, Wang, Xiaoli, Newall, Anthony T., Mukerji, Shohini

2017

Overview

Background There are substantial differences between the costs of medical masks and N95 respirators. Cost-effectiveness analysis is required to assist decision-makers evaluating alternative healthcare worker (HCW) mask/respirator strategies. This study aims to compare the cost-effectiveness of N95 respirators and medical masks for protecting HCWs in Beijing, China. Methods We developed a cost-effectiveness analysis model utilising efficacy and resource use data from two cluster randomised clinical trials assessing various mask/respirator strategies conducted in HCWs in Level 2 and 3 Beijing hospitals for the 2008–09 and 2009–10 influenza seasons. The main outcome measure was the incremental cost-effectiveness ratio (ICER) per clinical respiratory illness (CRI) case prevented. We used a societal perspective which included intervention costs, the healthcare costs of CRI in HCWs and absenteeism costs. Results The incremental cost to prevent a CRI case with continuous use of N95 respirators when compared to medical masks ranged from US $490–$1230 (approx. 3000-7600 RMB). One-way sensitivity analysis indicated that the CRI attack rate and intervention effectiveness had the greatest impact on cost-effectiveness. Conclusions The determination of cost-effectiveness for mask/respirator strategies will depend on the willingness to pay to prevent a CRI case in a HCW, which will vary between countries. In the case of a highly pathogenic pandemic, respirator use in HCWs would likely be a cost-effective intervention.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Absenteeism / China / Clinical trials / Cost analysis / Cost-Benefit Analysis / Cost-effectiveness / Decision analysis / Design / Disease control / Economic evaluation / Health aspects / Health care / Health Personnel / Healthcare worker / Healthcare-associated infection control / Hospitals / Humans / Immunization / Infectious Diseases / Influenza / Influenza, Human - economics / Influenza, Human - prevention & control / Internal Medicine / Intervention / Mask / Masks / Masks - economics / Masks - utilization / Medical Microbiology / Medical personnel / Medical research / Medicine / Medicine & Public Health / Models, Economic / Mortality / N95 respirator / Nosocomial infections / Pandemics / Parasitology / Practice / Protective equipment / Randomized Controlled Trials as Topic / Research Article / Respirators / Respiratory diseases / Respiratory Protective Devices - economics / Respiratory tract infection / Respiratory tract infections / Respiratory Tract Infections - economics / Respiratory Tract Infections - prevention & control / Seasons / Sensitivity analysis / Tropical Medicine / Ventilators, Mechanical - economics / Ventilators, Mechanical - utilization