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Cost of Illness for Five Major Foodborne Illnesses and Sequelae in Sweden

Sundström, Kristian LU (2018) In Applied Health Economics and Health Policy p.243-257
Abstract
Objectives
The main objective of this study was to derive cost estimates of five major foodborne illnesses (campylobacteriosis, salmonellosis, enterohemorrhagic Escherichia coli (EHEC), yersiniosis and shigellosis) in Sweden. These estimates provide a necessary contribution to perform future cost-benefit analyses aimed at reducing the burden of foodborne disease. A secondary aim was to obtain estimates of the true number of cases that occur in the community, thus providing necessary ground for calculating costs.

Methods
The true number of cases for each foodborne illness was simulated by multiplying the reported number of cases by sequential multipliers, one for each potential source of information loss about... (More)
Objectives
The main objective of this study was to derive cost estimates of five major foodborne illnesses (campylobacteriosis, salmonellosis, enterohemorrhagic Escherichia coli (EHEC), yersiniosis and shigellosis) in Sweden. These estimates provide a necessary contribution to perform future cost-benefit analyses aimed at reducing the burden of foodborne disease. A secondary aim was to obtain estimates of the true number of cases that occur in the community, thus providing necessary ground for calculating costs.

Methods
The true number of cases for each foodborne illness was simulated by multiplying the reported number of cases by sequential multipliers, one for each potential source of information loss about a case. This assessment of the true number of cases was then used to estimate the number of cases of sequelae for each illness. An incidence-based analysis was then used to calculate direct medical and non-medical costs, as well as indirect costs. Data for estimating the true number of cases for each illness were primarily based on an expert panel, while the derivation of costs mainly utilized national registries, databases and published literature.

Results
The estimated number of cases was between 7- and 11-fold higher than the reported number of cases, indicating the importance of taking information loss into account when calculating costs. By far the most common pathogen of the five was campylobacter, with an estimated 101,719 (90% credibility interval [CI] 59,640–158,025) human cases occurring annually. For salmonella, 19,678 (90% CI 8394–40,456) cases were estimated to occur each year, while the other three pathogens were less common, with a yearly incidence of approximately 2500–5500 cases each. The total cost for the five pathogens (including sequelae) amounted to €142 million annually. Campylobacter was the most costly pathogen, representing 69% of the total costs. Salmonellosis and EHEC constituted 18 and 9% of these costs, respectively, while yersiniosis and shigellosis represented approximately 2% each. Costs for sequelae were significant and accounted for approximately 50% of the total costs.

Conclusions
Our simulations indicated that campylobacter infection was more common and more costly than salmonella, EHEC, yersinia and shigella combined. Estimated costs for all illnesses were highly influenced by (1) considering potential information losses about cases in the population (which increased costs 7- to 11-fold), and (2) taking account of post-infection sequelae (which doubled the costs).
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Applied Health Economics and Health Policy
pages
15 pages
publisher
Springer
external identifiers
  • pmid:29313242
  • scopus:85044653467
ISSN
1175-5652
DOI
10.1007/s40258-017-0369-z
language
English
LU publication?
yes
id
00be4b1b-c8f7-418e-a2d0-2ddecd23cd2a
date added to LUP
2018-01-12 11:21:10
date last changed
2023-11-17 11:58:08
@article{00be4b1b-c8f7-418e-a2d0-2ddecd23cd2a,
  abstract     = {{<b>Objectives</b><br/>The main objective of this study was to derive cost estimates of five major foodborne illnesses (campylobacteriosis, salmonellosis, enterohemorrhagic Escherichia coli (EHEC), yersiniosis and shigellosis) in Sweden. These estimates provide a necessary contribution to perform future cost-benefit analyses aimed at reducing the burden of foodborne disease. A secondary aim was to obtain estimates of the true number of cases that occur in the community, thus providing necessary ground for calculating costs.<br/><br/><b>Methods</b><br/>The true number of cases for each foodborne illness was simulated by multiplying the reported number of cases by sequential multipliers, one for each potential source of information loss about a case. This assessment of the true number of cases was then used to estimate the number of cases of sequelae for each illness. An incidence-based analysis was then used to calculate direct medical and non-medical costs, as well as indirect costs. Data for estimating the true number of cases for each illness were primarily based on an expert panel, while the derivation of costs mainly utilized national registries, databases and published literature.<br/><br/><b>Results</b><br/>The estimated number of cases was between 7- and 11-fold higher than the reported number of cases, indicating the importance of taking information loss into account when calculating costs. By far the most common pathogen of the five was campylobacter, with an estimated 101,719 (90% credibility interval [CI] 59,640–158,025) human cases occurring annually. For salmonella, 19,678 (90% CI 8394–40,456) cases were estimated to occur each year, while the other three pathogens were less common, with a yearly incidence of approximately 2500–5500 cases each. The total cost for the five pathogens (including sequelae) amounted to €142 million annually. Campylobacter was the most costly pathogen, representing 69% of the total costs. Salmonellosis and EHEC constituted 18 and 9% of these costs, respectively, while yersiniosis and shigellosis represented approximately 2% each. Costs for sequelae were significant and accounted for approximately 50% of the total costs.<br/><b><br/>Conclusions</b><br/>Our simulations indicated that campylobacter infection was more common and more costly than salmonella, EHEC, yersinia and shigella combined. Estimated costs for all illnesses were highly influenced by (1) considering potential information losses about cases in the population (which increased costs 7- to 11-fold), and (2) taking account of post-infection sequelae (which doubled the costs).<br/>}},
  author       = {{Sundström, Kristian}},
  issn         = {{1175-5652}},
  language     = {{eng}},
  pages        = {{243--257}},
  publisher    = {{Springer}},
  series       = {{Applied Health Economics and Health Policy}},
  title        = {{Cost of Illness for Five Major Foodborne Illnesses and Sequelae in Sweden}},
  url          = {{http://dx.doi.org/10.1007/s40258-017-0369-z}},
  doi          = {{10.1007/s40258-017-0369-z}},
  year         = {{2018}},
}