The Rise of Valley Fever: Prevalence and Cost Burden of Coccidioidomycosis Infection in California

Abstract

Coccidioidomycosis (CM) is a fungal infection endemic in the southwestern United States (US). In California, CM incidence increased more than 213% (from 6.0/100,000 (2014) to 18.8/100,000 (2017)) and continues to increase as rates in the first half of 2018 are double that of 2017 during the same period. This cost-of-illness study provides essential information to be used in health planning and funding as CM infections continue to surge. We used a “bottom-up” approach to determine lifetime costs of 2017 reported incident CM cases in California. We defined CM natural history and used a societal approach to determine direct and discounted indirect costs using literature, national datasets, and expert interviews. The total lifetime cost burden of CM cases reported in 2017 in California is just under $700 million US dollars, with $429 million in direct costs and $271 million in indirect costs. Per person direct costs were highest for disseminated disease ($1,023,730), while per person direct costs were lowest for uncomplicated CM pneumonia ($22,039). Cost burden varied by county. This is the first study to estimate total costs of CM, demonstrating its huge cost burden for California.

Valley Fever: Environmental Risk Factors and Exposure Pathways Deduced from Field Measurements in California

“…The development of a vaccine has been elusive to date, and accurate diagnosis and treatment of the disease can be difficult [ 18 ]. Therefore, prevention through reasonable reduction in exposure is likely the best way to reduce incidence of the disease, human suffering, and the financial burden on health care [ 21 , 22 ].…”

Hands-On Ecological Restoration as a Nature-Based Health Intervention: Reciprocal Restoration for People and Ecosystems

“…In both Arizona and California, there has been detailed tracking of the total economic and specific health care costs associated with valley fever for at least two decades. A recent analysis of the lifetime cost from all infections alone is US $700 million, with per patient costs ranging from US $20,000 to US $1,000,000 (Wilson et al, 2019).…”

The Rise of Coccidioides: Forces Against the Dust Devil Unleashed

“…Furthermore, the market for a vaccine to prevent Valley fever is relatively small. While there is a very strong public case for preventing this disease (81), it is much more challenging to make a business model with a return on investment competitive with other opportunities for investors. It is likely that a Valley fever vaccine will only be developed if public resources, state or federal, are deemed appropriate for this purpose.…”