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Int J Environ Res Public Health. 2019 Mar 28;16(7). pii: E1113. doi: 10.3390/ijerph16071113.

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

Author information

1
Department of Clinical Pharmacy, University of California, San Francisco, CA 94118, USA. leslie.wilson@ucsf.edu.
2
Department of Clinical Pharmacy, University of California, San Francisco, CA 94118, USA. jie.tingjie@gmail.com.
3
Kaiser Permanente Fresno, Fresno, CA 93720, USA. Harold.H.Lin@kp.org.
4
Department of Clinical Pharmacy, University of California, San Francisco, CA 94118, USA. rahil.shah@ucsf.edu.
5
Kings County Department of Public Health, Hanford, CA 93230, USA. maclean.mlm@gmail.com.
6
Department of Medicine, University of California, San Francisco (UCSF), Fresno, CA 93701, USA. mpeterson@fresno.ucsf.edu.
7
Department of Medicine, University of California, San Francisco (UCSF), Fresno, CA 93701, USA. nstockamp@fresno.ucsf.edu.
8
Department of Medicine, University of California, San Francisco (UCSF), Fresno, CA 93701, USA. rlibke@fresno.ucsf.edu.
9
Department of Social Sciences, Humanities and Arts, University of California, Merced, CA 95343, USA. pbrown3@ucmerced.edu.

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.

KEYWORDS:

California; Valley fever; coccidioidomycosis; cost; cost-of-illness; economic analysis; infection; prevalence

PMID:
30925716
PMCID:
PMC6480346
DOI:
10.3390/ijerph16071113
[Indexed for MEDLINE]
Free PMC Article

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