Anne C. Haddix

Cost of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin

To assess the total medical costs and productivity losses associated with the 1993 waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, including the average cost per person with mild, moderate, and severe illness, we conducted a retrospective cost-of-illness analysis using data from 11 hospitals in the greater Milwaukee area and epidemiologic data collected during the outbreak. The total cost of outbreak-associated illness was

National Mass Drug Administration Costs for Lymphatic Filariasis Elimination

96.2 million:

Cost-effectiveness of universal screening for chlamydia and gonorrhea in US jails

31.7 million in medical costs and

An ounce of prevention … what are the returns?: Second edition, 1999

64.6 million in productivity losses. The average total costs for persons with mild, moderate, and severe illness were

Willingness to pay for prevention and treatment of lymphatic filariasis in Leogane, Haiti

116,

A cost-effectiveness evaluation of testing and treatment of Chlamydia trachomatis infection among asymptomatic women infected with Neisseria gonorrhoeae.

475, and

Prevention effectiveness : a guide to decision analysis and economic evaluation

7,808, respectively. The potentially high cost of waterborne disease outbreaks should be considered in economic decisions regarding the safety of public drinking water supplies.

Priorities among recommended clinical preventive services.

Background Because lymphatic filariasis (LF) elimination efforts are hampered by a dearth of economic information about the cost of mass drug administration (MDA) programs (using either albendazole with diethylcarbamazine [DEC] or albendazole with ivermectin), a multicenter study was undertaken to determine the costs of MDA programs to interrupt transmission of infection with LF. Such results are particularly important because LF programs have the necessary diagnostic and treatment tools to eliminate the disease as a public health problem globally, and already by 2006, the Global Programme to Eliminate LF had initiated treatment programs covering over 400 million of the 1.3 billion people at risk. Methodology/Principal Findings To obtain annual costs to carry out the MDA strategy, researchers from seven countries developed and followed a common cost analysis protocol designed to estimate 1) the total annual cost of the LF program, 2) the average cost per person treated, and 3) the relative contributions of the endemic countries and the external partners. Costs per person treated ranged from

Cost-effectiveness Analysis of a Rotavirus Immunization Program for the United States

0.06 to

Lessons from cost-effectiveness research for United States public health policy

2.23. Principal reasons for the variation were 1) the age (newness) of the MDA program, 2) the use of volunteers, and 3) the size of the population treated. Substantial contributions by governments were documented – generally 60%–90% of program operation costs, excluding costs of donated medications. Conclusions/Significance MDA for LF elimination is comparatively inexpensive in relation to most other public health programs. Governments and communities make the predominant financial contributions to actual MDA implementation, not counting the cost of the drugs themselves. The results highlight the impact of the use of volunteers on program costs and provide specific cost data for 7 different countries that can be used as a basis both for modifying current programs and for developing new ones.