142nd APHA Annual Meeting and Exposition

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307051
Economic Evaluation of 2012 Fungal Meningitis Outbreak in New River Valley

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Nargesalsadat Dorratoltaj, MS, MPH , Department of Population Health Sciences, Virginia Tech, Blacksburg, VA
Margaret O'Dell, MD, MFA , New River Health District, Virginia Department of Health, Christiansburg, VA
Page Bordwine, MPH, MT(ASCP) , New River Health District, Christiansburg, VA
Thomas Kerkering, MD, FACP, FIDSA , Carilion Clinic, Virginia Tech Carilion School of Medicine, Roanoke, VA
Kerry Redican, PhD, MPH, MSPH, CHES , Department of Population Health Sciences, Virginia Tech, Blacksburg, VA
Kaja Abbas, PhD, MPH , Department of Population Health Sciences, Virginia Tech, Blacksburg, VA
Objective:The objective of this study is to conduct an economic evaluation of the fungal meningitis outbreak response in New River Valley of Virginia from the local public health department and clinical perspectives. 

Background:The multi-state fungal meningitis outbreak started in September 2012 in Tennessee. The cause of the outbreak was traced to injection of contaminated lots of methylprednisolone acetate used in epidural steroid injections. New River Valley and Roanoke were the epicenter of this outbreak in Virginia, where two clinical centers administered the contaminated injections. 

Methods:Public health personnel, in collaboration with clinicians in local hospitals, monitored and followed up the exposed patients for 6 months and provided clinical care, including lab tests and hospitalizations. The health department continued the outbreak investigation until March 2013 to ascertain that all possible cases were identified and treated. None of the patients treated at the New River site met the case definition, as defined by CDC. We estimated the costs and epidemiological benefits of this outbreak response, and computed incremental cost-effectiveness ratio of the fungal meningitis outbreak response, from the local health department perspective.  

Results:Based on preliminary analysis, we estimated the expenditures of the local health department to be $30,493 and 73.5 disability adjusted life years (DALY) averted among the patients, for an incremental cost-effectiveness ratio of $415 per DALY averted.

Conclusions:From the local health department perspective, the cost of the outbreak response is $30,493 and the epidemiological benefits in New River Valley are 73.5 averted disability adjusted life years averted. We will include the clinical perspective to this analysis. 

Public Health Implications: The estimated incremental cost effectiveness ratio assists the local health department to assess the costs and benefits of the outbreak response, and in prioritization and allocation of limited public health resources.

Learning Areas:

Biostatistics, economics
Public health or related public policy

Learning Objectives:
Identify the costs and effectiveness of 2012 fungal meningitis outbreak response in New River Valley, Virginia. Evaluate the incremental cost-effectiveness ratio of the fungal meningitis outbreak response. Assess the incremental cost-effectiveness ratio to prioritize the limited resources of the local health department.

Keyword(s): Economic Analysis, Decision-Making

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD candidate at Virginia Tech and I do not have any conflict of interest to disclose.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.