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

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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)

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

Suggested Citation

  • R. Scott Braithwaite & Douglas Fridsma & Mark S. Roberts, 2006. "The Cost-Effectiveness of Strategies to Reduce Mortality from an Intentional Release of Aerosolized Anthrax Spores," Medical Decision Making, , vol. 26(2), pages 182-193, March.
    • Handle: RePEc:sae:medema:v:26:y:2006:i:2:p:182-193
    DOI: 10.1177/0272989X06286794
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    References listed on IDEAS

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    1. Wetter, D.C. & Daniell, W.E. & Treser, C.D., 2001. "Hospital preparedness for victims of chemical or biological terrorism," American Journal of Public Health, American Public Health Association, vol. 91(5), pages 710-716.
    2. Geiger, H.J., 2001. "Terrorism, biological weapons, and bonanzas: Assessing the real threat to public health," American Journal of Public Health, American Public Health Association, vol. 91(5), pages 708-709.
    3. Ron Brookmeyer & Elizabeth Johnson & Robert Bollinger, 2004. "Public health vaccination policies for containing an anthrax outbreak," Nature, Nature, vol. 432(7019), pages 901-904, December.
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    Cited by:

    1. Margaret L. Brandeau, 2019. "OR Forum—Public Health Preparedness: Answering (Largely Unanswerable) Questions with Operations Research—The 2016–2017 Philip McCord Morse Lecture," Operations Research, INFORMS, vol. 67(3), pages 700-710, May.

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