The Cost-Effectiveness of Strategies to Reduce Mortality from an Intentional Release of Aerosolized Anthrax Spores

R. Scott Braithwaite, Douglas Fridsma and Mark S. Roberts
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R. Scott Braithwaite: Yale University School of Medicine, Section of General Internal Medicine, West Haven VA CT Healthcare System, VACS 11 ACSL-G, 950 Campbell Avenue, West Haven, CT 06516 ronald.braithwaite@med.va.gov
Douglas Fridsma: Section of Biomedical Informatics, University Pittsburgh School of Medicine, Pittsburgh, PA
Mark S. Roberts: Section Decision Sciences and Clinical Systems Modeling, University Pittsburgh School of Medicine, Pittsburgh, PA

Medical Decision Making, 2006, vol. 26, issue 2, 182-193

Abstract: Background . Intentional exposures to aerosolized Bacillus anthracis spores have caused fatalities. Objective. To evaluate the cost-effectiveness of strategies to reduce mortality from future inhalational anthrax exposures. Methods. Computer cohort simulation of a 100,000-person single-site exposure (worst-case scenario) and a 100-person multiplesite exposure (resembling the recent US attack). For each scenario, universal vaccination and an emergency surveillance and response (ESR) system were compared with a default strategy that assumed eventual discovery of the exposure. Results. If an exposure was unlikely to occur or was small in scale, neither vaccination nor an ESR system was cost-effective. If an exposure was certain and large in scale, an ESR system was more cost-effective than vaccination ($73 v. $29,600 per life-year saved), and a rapid response saved more lives than improved surveillance. Conclusions. Strategies to reduce deaths from anthrax attacks are cost-effective only if large exposures are certain. A faster response is more beneficial than enhanced surveillance

Keywords: bioterrorism; anthrax; cost-effectiveness (search for similar items in EconPapers)
Date: 2006
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:26:y:2006:i:2:p:182-193

DOI: 10.1177/0272989X06286794

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