OBJECTIVES: The economic impact of seasonal influenza (flu) on at-risk populations is well-documented in high-income countries. However, its effects are less understood in low and middle-income countries (LMICs), such as Algeria. We retrospectively estimated the economic burden of influenza from a healthcare payer and societal perspectives.

METHODS: Following best practice guidelines, we employed a micro-costing approach to retrospectively estimate the economic resources expended in treating seasonal influenza from both public and societal perspectives. Our assessment was informed by local retrospective data (2010-2013, flu seasons) and robust literature estimates. The cost inputs of our evaluation were expressed in US dollars as the mean value of years 2010-2013. We conducted one-way deterministic sensitivity analyses (SA) to account for potential variability in the inputs.

RESULTS: Based on the observed three-year mean incidence of 40.6% in the total population, we estimated the mean annual direct cost of influenza at $280million. Inpatient (3.7% of flu cases) and symptomatic treatment represent 60% ($167million), and 21% ($58million) of those resources, respectively. Low observed vaccination coverage rates (2.4%, VCR), equate to 3.9% (flu vaccines acquisition costs) of the direct annual costs.

From a societal perspective, additional $54million related to productivity losses were estimated. Sensible cost drivers were the incidence of disease, the cost of hospitalization and the hospital duration stay, as estimated in the SA.

CONCLUSIONS: Our analysis revealed that hospitalizations, followed by symptomatic treatment constitute the primary cost-drivers of typical seasonal influenza expenditure in Algeria. Presented figures aim to support efficient allocation of resources and informed decision-making. Future research studying the effects of increased VCR, particularly among vulnerable groups such as the elderly and immunocompromised, with more recent data is needed.

Conflicts of interest:

AA, JBH and AL are employees of Sanofi and might own stocks at the company.

MG have no conflicts of interest to disclose.