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Med Decis Making. 2006 Mar-Apr;26(2):182-93.

The cost-effectiveness of strategies to reduce mortality from an intentional release of aerosolized anthrax spores.

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  • 1Section of General Internal Medicine, Yale University School of Medicine, 950 Campbell Avenue, West Haven, CT 06516, USA. ronald.braithwaite@med.va.gov

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 multiple-site 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.

[PubMed - indexed for MEDLINE]
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