Benedictus A, Hogeveen H, Berends B R
Interfaculty Institute for Risk Assessment Sciences (IRAS), Division of Veterinary Public Health (VPH), Utrecht University, The Netherlands.
Prev Vet Med. 2009 Jun 1;89(3-4):212-22. doi: 10.1016/j.prevetmed.2009.03.001. Epub 2009 Apr 14.
Since 1996, bovine spongiform encephalopathy (BSE) in cattle has been linked to a new variant of Creutzfeldt-Jakob disease (vCJD), a fatal brain disease in man. This paper assessed the cost-effectiveness of BSE control strategies instituted by the European Commission. In a Monte Carlo simulation model, a non-intervention baseline scenario was compared to three intervention strategies: removal of specified risk materials from slaughter animals, post-mortem testing for BSE and the culling of feed and age cohorts of BSE cases. The food risk in the baseline scenario ranged from 16.98 lost life years in 2002 to 2.69 lost life years in 2005. Removing specified risk materials removal practices, post-mortem testing and post-mortem testing plus cohort culling reduced this risk with 93%, 82.7% and 83.1%. The estimated cost-effectiveness of all BSE measures in The Netherlands ranged from 4.3 million euros per life year saved in 2002 to 17.7 million euros in 2005. It was discussed that the cost-effectiveness of BSE control strategies will further deviate from regular health economics thresholds as BSE prevalence and incidence declines.
自1996年以来，牛的牛海绵状脑病（BSE）与一种新型克雅氏病（vCJD）有关，后者是一种致命的人类脑部疾病。本文评估了欧盟委员会制定的BSE控制策略的成本效益。在一个蒙特卡洛模拟模型中，将非干预基线情景与三种干预策略进行了比较：从屠宰动物中去除特定风险物质、BSE的死后检测以及对BSE病例的饲料和年龄组进行扑杀。基线情景中的食物风险从2002年的16.98个生命年损失到2005年的2.69个生命年损失。去除特定风险物质、死后检测以及死后检测加年龄组扑杀分别将这种风险降低了93%、82.7%和83.1%。荷兰所有BSE措施的估计成本效益从2002年每挽救一个生命年430万欧元到2005年的1770万欧元不等。讨论指出，随着BSE流行率和发病率的下降，BSE控制策略的成本效益将进一步偏离常规卫生经济学阈值。
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