National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven.
Cost-Utility Analysis to Control Campylobacter on Chicken Meat—Dealing with Data Limitations
Article first published online: 23 OCT 2007
Volume 27, Issue 4, pages 815–830, August 2007
How to Cite
Mangen, M.-J. J., Havelaar, A. H., Poppe, K. P., De Wit, G. A. and the CARMA Project Team (2007), Cost-Utility Analysis to Control Campylobacter on Chicken Meat—Dealing with Data Limitations. Risk Analysis, 27: 815–830. doi: 10.1111/j.1539-6924.2007.00925.x
- Issue published online: 23 OCT 2007
- Article first published online: 23 OCT 2007
- chicken meat;
- cost-utility analysis;
- disability-adjusted life years (DALY);
- intervention costs
The current article describes the economic evaluation of interventions to control Campylobacter on chicken meat by means of a cost-utility analysis. Apart from the methodology used, the main focus of this article is on data gaps and assumptions made, and their impact on results and conclusions. The direct intervention costs, the relative risk, the disease burden (expressed in disability-adjusted life years (DALYs)), and the costs of illness for the various interventions are necessary inputs for the cost-utility analysis. The cost-utility ratio (CUR)—the measure for efficiency—is expressed in net costs per avoided DALY. Most data gaps were of a biological order, but for some interventions, information on costs was also scarce. As a consequence, assumptions had to be made, which had some impact on the estimated CUR. A higher (lower) incidence of Campylobacter infections associated with chicken meat, higher (lower) effectiveness, and lower (higher) intervention costs, respectively, would result in absolute better (worse) CUR estimates. By taking the perspective of all consumers eating Dutch chicken meat, rather than only the Dutch society, absolute better CUR estimates could be obtained. Indirect costs or a shift toward non-Dutch chicken meat would both result in higher CUR estimates. Despite the assumptions made, three interventions showed for most of the applied sensitivity analyses relatively favorable CUR estimates: limiting fecal leakage during processing, carcass decontamination by dipping in a chemical solution, and the phage therapy. However, all three do have some clauses.