The study, recently published in the New Zealand Medical Journal, found the average cost for a person hospitalised for the infection was $17,000 and $97,000 per person in intensive care.
In future pandemics hospital services "could be overwhelmed and so the death rate could shoot up with people dying at home", said the study's lead author, Associate Professor Nick Wilson.
The costs of the infection showed the value of further work on prevention such as vaccination, and investment in pandemic planning and other control measures.
There was a lack of studies on pandemic vaccine uptake and the effectiveness of health protection messages in media campaigns, the study found.A
Hitting hard
$31m cost to hospitals
1122 people in hospital
102 needed ICU treatment
49 people killed