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Suijkerbuijk AWM, Over EAB, Opsteegh M, Deng H, van Gils PF, Marinovic AAB, Lambooij M, Polder JJ, Feenstra TL, van der Giessen JWB, de Wit GA, Mangen MJ. A social cost-benefit analysis of two One Health interventions to prevent toxoplasmosis. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In the Netherlands, toxoplasmosis ranks third in disease burden among foodborne pathogens, with an estimated health loss of 1,900 Disability Adjusted Life Years and a cost-of-illness estimated at €44 million annually. We performed a Social Cost-Benefit Analysis (SCBA) to evaluate the net value of two potential interventions, freezing meat and improving biosecurity in pig farms, for the Dutch society.
Methods
We assessed the costs and benefits of the two interventions and compared them with the current practice of education, especially during pregnancy. A ‘minimum scenario’ and a ‘maximum scenario’ was assumed, using input parameters with least benefits to society and input parameters with most benefits to society, respectively.
Results
The freezing meat intervention was far more effective than the biosecurity intervention. Despite high freezing costs, freezing two meat products: steak tartare and mutton leg yielded net social benefits in both the minimum and maximum scenario, ranging from €10.6 million to €31 million for steak tartare and €0.6 million to €1.5 million for mutton leg. The biosecurity intervention would result in net costs in all scenarios ranging from €1 million to €2.5 millions.
Conclusions
From a public health perspective (i.e. reducing the burden of toxoplasmosis) freezing steak tartare and leg of mutton is to be considered.
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Affiliation(s)
| | | | | | - H Deng
- RIVM, Bilthoven, Netherlands
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de Wit GA, van Gils PF, Over EAB, Suijkerbuijk AWM, Lokkerbol J, Smit F, Spit WJ, Evers SMAA, de Kinderen RJA. Social cost-benefit analysis of regulatory policies to reduce alcohol use in The Netherlands. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
If all costs and all benefits of alcohol use are expressed in monetary terms, the net costs were 2,3 to 4,2 billion euro in 2013. Examples of the costs of alcohol are less productivity at work, costs of police and justice and traffic accidents.
Methods
In this study three regulatory policies have been modelled using the Social Cost-Benefit Analysis (SCBA) approach. Regulatory policies aimed at curbing alcohol consumption were (1) an increase in excise taxes, (2) a reduction of the number of sales venues, and (3) a total mediaban for advertising alcohol.
Results
In the long run, over a period of 50 years, an increase in excise taxes of 50% will result in societal benefits of 4.5 to 10.7 billion euro, an increase of excise taxes of 200% will result in societal benefits of 12.2 to 35.8 billion euro. The societal benefits of closure of 10% of sales venues are estimated at 1.8 to 4.3 billion euro after 50 years, and at 4.6 to 10.7 billion euro when 25% of sales venues would be closed. The societal benefits of a mediaban would amount to 3.5 to 7.8 billion euro after 50 years, but this estimate is surrounded by uncertainty.
Conclusions
Regulatory policies aimed at reducing the amount of alcohol consumed, such as a further increase of excise taxes, a reduction of the number of sales venues and a total mediaban, will result in savings for society at large. However, costs and benefits are spread unequally over the different stakeholders.
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Affiliation(s)
| | | | | | | | | | - F Smit
- Trimbos Institute, Utrecht, Netherlands
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de Kinderen RJA, Wijnen BFM, Evers SMAA, Hiligsmann M, Paulus ATG, de Wit GA, van Gils PF, Over EAB, Suijkerbuijk AWM, Smit F. Social cost-benefit analysis of tobacco control policies in the Netherlands. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In the Netherlands approximately 23% of the population of 15 years and older smokes. The main research questions were to identify what social costs- and benefits can be expected when various tobacco control policies would be implemented in The Netherlands, how do costs and benefits change over time, and which sectors in society could expect to incur costs and in which sectors accrue profits.
Methods
A SCBA was conducted using a combination of the Chronic Disease Model developed by the National Institute for Public Health and the Environment (RIVM), the SimSmoke model and a specially designed excel model. Policies included both tax increases (i.e. increase of excise tax on tobacco of 5% or 10% each year) and a policy package as proposed by the World Health Organization (i.e. including mass media campaigns and mediabans).
Results
When no new policy measures are implemented, the prevalence of smoking will decrease by 2.3 percentage points over the next 35 years. The policies reviewed in this report have the potential to decrease smoking prevalence by 14.2 percentage points (and in a ‘smoking-free society scenario, by as much as 17.4 percentage points). Furthermore, the results show that the intervention costs for all scenarios are minimal, and that investing in health is beneficial as seen from both the public health and fiscal perspective.
Conclusions
This study demonstrated that reducing the prevalence of smoking has beneficial effects for various stakeholders within the Dutch society: such as employers (e.g. increased productivity) and consumers (e.g. increase quality of life).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - F Smit
- Trimbos Institute, Utrecht, Netherlands
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Over EAB, van Gils PF, Suijkerbuijk AWM, Lokkerbo J, de Wit GA. Social cost-benefit analysis of Cognitive Behavioral Therapy for alcohol and cannabis addiction. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A considerable number of people with an alcohol or cannabis addiction currently do not receive addiction care. Some hundreds of thousands persons in the Netherlands suffer from alcohol dependency, while some tens of thousands adolescents suffer from cannabis addiction.
Methods
A (hypothetically) enhanced uptake of CBT in specialized addiction care centers was modeled using the SCBA approach. Two SCBA’s were performed: one with respect to alcohol addiction and the other regarding cannabis addiction among adolescents.
Results
Per person treated with CGT, these benefits accumulate to about 12,000 euro (range 10.000 - 14.000 euro). These profits originate from improved health and less mortality, improved quality of life and higher productivity. A decrease in the number of persons with an alcohol addiction will also lead to lower costs for police and justice following from less criminal activities. Furthermore, CGT is effective as treatment for adolescents with cannabis addiction. Per person treated with CGT, societal benefits accumulate to about 11.000 euro (range 9.700 - 13.000 euro). Here, the net benefits arise from improved health, improved quality of life, reduced early school leaving and higher incomes for those clients who have successfully participated in CGT in addiction care.
Conclusions
This study shows that society can benefit from an increase in people treated with CGT in specialized addiction care. Such an increase in number of people treated could for instance be realized by educational programs for professionals who come across people with dependency problems, such as general practitioners, professionals working in emergency care and youth care.
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Suijkerbuijk AWM, van Gils PF, Bonačić Marinović AA, Feenstra TL, Kortbeek LM, Mangen MJJ, Opsteegh M, de Wit GA, van der Giessen JWB. The design of a Social Cost-Benefit Analysis of preventive interventions for toxoplasmosis: An example of the One Health approach. Zoonoses Public Health 2017; 65:185-194. [PMID: 29131528 DOI: 10.1111/zph.12417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Indexed: 01/01/2023]
Abstract
Toxoplasma gondii infections cause a large disease burden in the Netherlands, with an estimated health loss of 1,900 Disability Adjusted Life Years and a cost-of-illness estimated at €44 million annually. Infections in humans occur via exposure to oocysts in the environment and after eating undercooked meat containing tissue cysts, leading to asymptomatic or mild symptoms, but potentially leading to the development of ocular toxoplasmosis. Infection in pregnant women can lead to stillbirth and disorders in newborns. At present, prevention is only targeted at pregnant women. Cat vaccination, freezing of meat destined for undercooked consumption and enhancing biosecurity in pig husbandries are possible interventions to prevent toxoplasmosis. As these interventions bear costs for sectors in society that differ from those profiting from the benefits, we perform a social cost-benefit analysis (SCBA). In an SCBA, costs and benefits of societal domains affected by the interventions are identified, making explicit which stakeholder pays and who benefits. Using an epidemiological model, we consider transmission of T. gondii after vaccination of all owned cats or cats at livestock farms. To identify relevant high-risk meat products that will be eaten undercooked, a quantitative microbial risk assessment model developed to attribute predicted T. gondii infections to specific meat products will be used. In addition, we evaluate serological monitoring of pigs at slaughter followed by an audit and tailor made advice for farmers in case positive results were found. The benefits will be modelled stochastically as reduction in DALYs and monetized in Euro's following reference prices for DALYs. If the balance of total costs and benefits is positive, this will lend support to implementation of these preventive interventions at the societal level. Ultimately, the SCBA will provide guidance to policy makers on the most optimal intervention measures to reduce the disease burden of T. gondii in the Netherlands.
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Affiliation(s)
- A W M Suijkerbuijk
- Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - P F van Gils
- Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - A A Bonačić Marinović
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - T L Feenstra
- Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Department of Epidemiology, University of Groningen, Groningen, The Netherlands
| | - L M Kortbeek
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - M-J J Mangen
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - M Opsteegh
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - G A de Wit
- Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J W B van der Giessen
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Polder JJ, van Gils PF, Kok L, Talhout R, Feenstra TL. [Costs and benefits of smoking]. Ned Tijdschr Geneeskd 2017; 160:D833. [PMID: 28181894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
- Two recent societal cost-benefit analyses have documented the costs of smoking and the cost-effectiveness of preventing smoking.- Smoking costs the Netherlands society EUR 33 billion per year.- The majority of this is the monetary value of health loss; these are "soft" euros that cannot be re-spent.- There is not a great deal of difference between costs and benefits when expressed in "hard" euros, which means that there is no clear business case for anti-smoking policy.- The greatest benefit of discouraging smoking is improved health for the individual and increased productivity for the business sector; however, the benefits cannot be easily realised, because even in the most favourable scenario the number of smokers will decrease slowly.- Excise duties seem to offer the most promising avenue for combating smoking. The benefits of anti-smoking policy, therefore, consist mainly of tax revenues for the government.- Stringent policy is required to transform tax revenues into health gains.
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Suijkerbuijk AWM, van Gils PF, Greeven PGJ, de Wit GA. [Cost-effectiveness of addiction care]. Tijdschr Psychiatr 2015; 57:498-507. [PMID: 26189418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND A large number of interventions are available for the treatment of addiction. Professionals need to know about the effectiveness and cost-effectiveness of interventions so they can prioritise appropriate interventions for the treatment of addiction. AIM To provide an overview of the scientific literature on the cost-effectiveness of addiction treatment for alcohol- and drug-abusers. METHOD We searched the databases Medline and Centre for Reviews and Dissemination. To be relevant for our study, articles had to focus on interventions in the health-care setting, have a Western context and have a health-related outcome measure such as quality adjusted life years (QALY). Twenty-nine studies met our inclusion criteria: 15 for alcohol and 14 for drugs. RESULTS The studies on alcohol addiction related mainly to brief interventions. They proved to be cost-saving or had a favourable incremental cost-effectiveness ratio (ICER), remaining below the threshold of € 20,000 per QALY. The studies on drug addiction all involved pharmacotherapeutic interventions. In the case of 10 out of 14 interventions, the ICER was less than € 20,000 per QALY. CONCLUSION Almost all of the interventions studied were cost-saving or cost-effective. Many studies consider only health-care costs. Additional research, for instance using a social cost-benefit analysis, could provide more details about the costs of addiction and about the impact that an intervention could have in these/the costs.
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