Economic Effects of Introducing Alternative Salmonella Control Strategies in Sweden

Sundström, Kristian; Wahlström, Helene; Ivarsson, Sofie; Lewerin, Susanna Sternberg

doi:10.1371/journal.pone.0096446

Cited by 20 publications

(17 citation statements)

References 22 publications

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“…The costs of controlling foodborne diseases in food-producing animals are high and some studies have investigated the effect that a relaxation of the Swedish Salmonella control programme in food-producing animals would have on public health and societal costs [ 34 , 35 ]. They concluded that the number of reported domestic salmonellosis cases would increase substantially and the net cost effects would therefore be negative.…”

Section: Impact Measurements Of Foodborne Diseasementioning

confidence: 99%

Food safety challenges and One Health within Europe

2018

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This review discusses food safety aspects of importance from a One Health perspective, focusing on Europe. Using examples of food pathogen/food commodity combinations, spread of antimicrobial resistance in the food web and the risk of transmission of zoonotic pathogens in a circular system, it demonstrates how different perspectives are interconnected. The chosen examples all show the complexity of the food system and the necessity of using a One Health approach. Food safety resources should be allocated where they contribute most One Health benefits. Data on occurrence and disease burden and knowledge of source attribution are crucial in assessing costs and benefits of control measures. Future achievements in food safety, public health and welfare will largely be based on how well politicians, researchers, industry, national agencies and other stakeholders manage to collaborate using the One Health approach. It can be concluded that closer cooperation between different disciplines is necessary to avoid silo thinking when addressing important food safety challenges. The importance of this is often mentioned, but more proof of concept is needed by the research community.

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Section: Impact Measurements Of Foodborne Diseasementioning

confidence: 99%

Food safety challenges and One Health within Europe

2018

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“…The costs related to VSCs and VSLs may potentially constitute a major part of the total costs [ 70 ] and excluding them probably leads to a considerable UE of the total societal costs. One study, in which the remaining life expectancy of persons who die as a result of salmonella infection was considered, found that including VSLs had only a minor impact on expected costs [ 4 ]. Although this study used VSL values that decrease proportionately with age, which is not supported by most studies [ 71 ], it nevertheless provides an indication of how much VSL costs would increase if age is considered for the main illnesses (for which the average age of cases that do not survive is rather high).…”

Section: Discussionmentioning

confidence: 99%

“…In Sweden, COI has previously been calculated for campylobacter and enterohemorrhagic Escherichia coli (EHEC), including a limited number of sequelae [ 3 ]. The method has also been used to test whether the Swedish salmonella control program should be modified based on a CBA [ 4 ]. On the other hand, the WTP approach includes intangible costs but only considers those parts of the direct and indirect costs that directly affect an individual.…”

Section: Introductionmentioning

confidence: 99%

Cost of Illness for Five Major Foodborne Illnesses and Sequelae in Sweden

Sundström

2018

Appl Health Econ Health Policy

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ObjectivesThe main objective of this study was to derive cost estimates of five major foodborne illnesses (campylobacteriosis, salmonellosis, enterohemorrhagic Escherichia coli (EHEC), yersiniosis and shigellosis) in Sweden. These estimates provide a necessary contribution to perform future cost-benefit analyses aimed at reducing the burden of foodborne disease. A secondary aim was to obtain estimates of the true number of cases that occur in the community, thus providing necessary ground for calculating costs.MethodsThe true number of cases for each foodborne illness was simulated by multiplying the reported number of cases by sequential multipliers, one for each potential source of information loss about a case. This assessment of the true number of cases was then used to estimate the number of cases of sequelae for each illness. An incidence-based analysis was then used to calculate direct medical and non-medical costs, as well as indirect costs. Data for estimating the true number of cases for each illness were primarily based on an expert panel, while the derivation of costs mainly utilized national registries, databases and published literature.ResultsThe estimated number of cases was between 7- and 11-fold higher than the reported number of cases, indicating the importance of taking information loss into account when calculating costs. By far the most common pathogen of the five was campylobacter, with an estimated 101,719 (90% credibility interval [CI] 59,640–158,025) human cases occurring annually. For salmonella, 19,678 (90% CI 8394–40,456) cases were estimated to occur each year, while the other three pathogens were less common, with a yearly incidence of approximately 2500–5500 cases each. The total cost for the five pathogens (including sequelae) amounted to €142 million annually. Campylobacter was the most costly pathogen, representing 69% of the total costs. Salmonellosis and EHEC constituted 18 and 9% of these costs, respectively, while yersiniosis and shigellosis represented approximately 2% each. Costs for sequelae were significant and accounted for approximately 50% of the total costs.ConclusionsOur simulations indicated that campylobacter infection was more common and more costly than salmonella, EHEC, yersinia and shigella combined. Estimated costs for all illnesses were highly influenced by (1) considering potential information losses about cases in the population (which increased costs 7- to 11-fold), and (2) taking account of post-infection sequelae (which doubled the costs).Electronic supplementary materialThe online version of this article (10.1007/s40258-017-0369-z) contains supplementary material, which is available to authorized users.

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“…One study, in which the remaining life expectancy of persons who die as a result of salmonella infection was considered, found that including VSLs had only a minor impact on expected costs [4]. Although this study used VSL values that decrease proportionately with age, which is not supported by most studies [71], it nevertheless provides an indication of how much VSL costs would increase if age is considered for the main illnesses (for which the average age of cases that do not survive is rather high).…”

Section: Discussionmentioning

confidence: 99%

A Systematic and Critical Review of Model-Based Economic Evaluations of Pharmacotherapeutics in Patients with Bipolar Disorder

Mohiuddin

2014

Appl Health Econ Health Policy

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Objectives The main objective of this study was to derive cost estimates of five major foodborne illnesses (campylobacteriosis, salmonellosis, enterohemorrhagic Escherichia coli (EHEC), yersiniosis and shigellosis) in Sweden. These estimates provide a necessary contribution to perform future cost-benefit analyses aimed at reducing the burden of foodborne disease. A secondary aim was to obtain estimates of the true number of cases that occur in the community, thus providing necessary ground for calculating costs. Methods The true number of cases for each foodborne illness was simulated by multiplying the reported number of cases by sequential multipliers, one for each potential source of information loss about a case. This assessment of the true number of cases was then used to estimate the number of cases of sequelae for each illness. An incidence-based analysis was then used to calculate direct medical and non-medical costs, as well as indirect costs. Data for estimating the true number of cases for each illness were primarily based on an expert panel, while the derivation of costs mainly utilized national registries, databases and published literature. Results The estimated number of cases was between 7-and 11-fold higher than the reported number of cases, indicating the importance of taking information loss into account when calculating costs. By far the most common pathogen of the five was campylobacter, with an estimated 101,719 (90% credibility interval [CI] 59,640-158,025) human cases occurring annually. For salmonella, 19,678 (90% CI 8394-40,456) cases were estimated to occur each year, while the other three pathogens were less common, with a yearly incidence of approximately 2500-5500 cases each. The total cost for the five pathogens (including sequelae) amounted to €142 million annually. Campylobacter was the most costly pathogen, representing 69% of the total costs. Salmonellosis and EHEC constituted 18 and 9% of these costs, respectively, while yersiniosis and shigellosis represented approximately 2% each. Costs for sequelae were significant and accounted for approximately 50% of the total costs. Conclusions Our simulations indicated that campylobacter infection was more common and more costly than salmonella, EHEC, yersinia and shigella combined. Estimated costs for all illnesses were highly influenced by (1) considering potential information losses about cases in the population (which increased costs 7-to 11-fold), and (2) taking account of postinfection sequelae (which doubled the costs). Key Points for Decision MakersThis study estimates the difference between registered and actual number of cases in the community for five major foodborne diseases. Potential post-infection sequelae are included in the analysis. These considerations are crucial in order to assess the actual societal burden of the five pathogens.The study also estimates total societal costs and costs per case for the five pathogens, results that can be utilized in future cost-benefit or cost-effectiveness studies.

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Economic Effects of Introducing Alternative Salmonella Control Strategies in Sweden

Cited by 20 publications

References 22 publications

Food safety challenges and One Health within Europe

Food safety challenges and One Health within Europe

Cost of Illness for Five Major Foodborne Illnesses and Sequelae in Sweden

A Systematic and Critical Review of Model-Based Economic Evaluations of Pharmacotherapeutics in Patients with Bipolar Disorder

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