Division of Infectious Diseases and Tropical Medicine, Department of Medicine 1, Medical University of Vienna, Vienna, Austria.
Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany.
PLoS Negl Trop Dis. 2019 Jan 31;13(1):e0007110. doi: 10.1371/journal.pntd.0007110. eCollection 2019 Jan.
Cystic echinococcosis (CE) is a globally occurring zoonosis, whereas alveolar echinococcosis (AE) is endemic only in certain parts of the Northern Hemisphere. The socioeconomic impact of human echinococcosis has been shown to be considerable in highly endemic regions. However, detailed data on direct healthcare-related costs associated with CE and AE are scarce for high income countries. The aim of this study was to evaluate direct costs of human disease caused by CE and AE in Austria.
Clinical data from a registry maintained at a national reference center for echinococcosis at the Medical University of Vienna were obtained for the years 2012-2014. These data were used in conjunction with epidemiological data from Austria's national disease reporting system and diagnostic reference laboratory for echinococcosis to assess nationwide costs attributable to CE and AE.
In Austria, total modelled direct costs were 486,598€ (95%CI 341,825€ - 631,372€) per year for CE, and 683,824€ (95%CI 469,161€ - 898,486€) for AE. Median costs per patient with AE from diagnosis until the end of a 10-year follow-up period were 30,832€ (25th- 75th percentile: 23,197€ - 31,220€) and 62,777€ (25th- 75th percentile: 60,806€ - 67,867€) for inoperable and operable patients, respectively. Median costs per patients with CE from diagnosis until end of follow-up after 10 years were 16,253€ (25th- 75th percentile: 8,555€ - 24,832€) and 1,786€ (25th- 75th percentile: 736€ - 2,146€) for patients with active and inactive cyst stages, respectively. The first year after inclusion was the most cost-intense year in the observed period, with hospitalizations and albendazole therapy the main contributors to direct costs.
This study provides detailed information on direct healthcare-related costs associated with CE and AE in Austria, which may reflect trends for other high-income countries. Surgery and albendazole therapy, due to surprisingly high drug prices, were identified as important cost-drivers. These data will be important for cost-effectiveness analyses of possible prevention programs.
包虫病（CE）是一种在全球范围内流行的动物源性传染病，而泡型包虫病（AE）仅在北半球的某些地区流行。在高度流行地区，人类包虫病的社会经济影响已被证明是相当大的。然而，对于高收入国家来说，与 CE 和 AE 相关的直接医疗保健相关成本的详细数据仍然很少。本研究旨在评估奥地利 CE 和 AE 引起的人类疾病的直接成本。
从维也纳医科大学国家包虫病参考中心维护的登记处获得 2012-2014 年的临床数据。结合奥地利国家疾病报告系统和包虫病诊断参考实验室的流行病学数据，评估与 CE 和 AE 相关的全国范围内的成本。
在奥地利，CE 的模型化直接总成本为每年 486,598 欧元（95%CI 341,825 欧元-631,372 欧元），AE 为每年 683,824 欧元（95%CI 469,161 欧元-898,486 欧元）。从诊断到 10 年随访结束时，每位 AE 患者的中位成本分别为 30,832 欧元（25% - 75% 分位数：23,197 欧元-31,220 欧元）和 62,777 欧元（25% - 75% 分位数：60,806 欧元-67,867 欧元）对于不可手术和可手术患者。CE 的中位成本从诊断到 10 年后随访结束分别为每位患者 16,253 欧元（25% - 75% 分位数：8,555 欧元-24,832 欧元）和 1,786 欧元（25% - 75% 分位数：736 欧元-2,146 欧元）对于活动性和非活动性囊型阶段的患者。纳入后的第一年是观察期间成本最高的一年，住院治疗和阿苯达唑治疗是直接成本的主要贡献者。
本研究提供了奥地利 CE 和 AE 相关直接医疗保健相关成本的详细信息，这可能反映了其他高收入国家的趋势。由于令人惊讶的高药物价格，手术和阿苯达唑治疗被确定为重要的成本驱动因素。这些数据对于可能的预防计划的成本效益分析将非常重要。
