An economic evaluation of preclinical testing strategies compared to the compulsory scrapie flock scheme in the control of classical scrapie.

Cost-benefit is rarely combined with nonlinear dynamic models when evaluating control options for infectious diseases. The current strategy for scrapie in Great Britain requires that all genetically susceptible livestock in affected flocks be culled (Compulsory Scrapie Flock Scheme or CSFS). However, this results in the removal of many healthy sheep, and a recently developed pre-clinical test for scrapie now offers a strategy based on disease detection. We explore the flock level cost-effectiveness of scrapie control using a deterministic transmission model and industry estimates of costs associated with genotype testing, pre-clinical tests and the value of a sheep culled. Benefit was measured in terms of the reduction in the number of infected sheep sold on, compared to a baseline strategy of doing nothing, using Incremental Cost Effectiveness analysis to compare across strategies. As market data was not available for pre-clinical testing, a threshold analysis was used to set a unit-cost giving equal costs for CSFS and multiple pre-clinical testing (MT, one test each year for three consecutive years). Assuming a 40% within-flock proportion of susceptible genotypes and a test sensitivity of 90%, a single test (ST) was cheaper but less effective than either the CSFS or MT strategies (30 infected-sales-averted over the lifetime of the average epidemic). The MT strategy was slightly less effective than the CSFS and would be a dominated strategy unless preclinical testing was cheaper than the threshold price of £6.28, but may be appropriate for flocks with particularly valuable livestock. Though the ST is not currently recommended, the proportion of susceptible genotypes in the national flock is likely to continue to decrease; this may eventually make it a cost-effective alternative to the MT or CSFS.

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PID https://www.doi.org/10.1371/journal.pone.0032884
PID pmc:PMC3296747
PID pmid:22412943
URL https://researchonline.lshtm.ac.uk/id/eprint/2534971/1/pone.0032884.pdf
URL http://dx.doi.org/10.1371/journal.pone.0032884
URL http://eprints.gla.ac.uk/64684/
URL https://ui.adsabs.harvard.edu/abs/2012PLoSO...732884B/abstract
URL http://hdl.handle.net/20.500.11820/31e4a7f3-ee33-4cce-9005-eeb63241578c
URL http://eprints.gla.ac.uk/64684/1/64684.pdf
URL http://europepmc.org/articles/PMC3296747
URL https://dx.plos.org/10.1371/journal.pone.0032884
URL https://www.pure.ed.ac.uk/ws/files/7910146/An_Economic_Evaluation_of_Preclinical_Testing_Strategies_Compared_to_the_Compulsory_Scrapie_Flock_Scheme_in_the_Control_of_Classical_Scrapie.pdf
URL http://www.scopus.com/inward/record.url?scp=84857815173&partnerID=8YFLogxK
URL https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296747
URL https://paperity.org/p/61256900/an-economic-evaluation-of-preclinical-testing-strategies-compared-to-the-compulsory
URL https://www.research.ed.ac.uk/portal/files/7910146/An_Economic_Evaluation_of_Preclinical_Testing_Strategies_Compared_to_the_Compulsory_Scrapie_Flock_Scheme_in_the_Control_of_Classical_Scrapie.pdf
URL https://www.research.ed.ac.uk/portal/en/publications/an-economic-evaluation-of-preclinical-testing-strategies-compared-to-the-compulsory-scrapie-flock-scheme-in-the-control-of-classical-scrapie(31e4a7f3-ee33-4cce-9005-eeb63241578c).html
URL http://dx.plos.org/10.1371/journal.pone.0032884
URL http://europepmc.org/articles/PMC3296747?pdf=render
URL https://doaj.org/toc/1932-6203
URL https://core.ac.uk/display/46169511
URL http://researchonline.lshtm.ac.uk/2534971/
URL https://academic.microsoft.com/#/detail/2162715421
URL http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0032884
URL https://doi.org/10.1371/journal.pone.0032884
URL https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0032884&type=printable
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Access Right Open Access
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Author Lisa Boden, 0000-0002-9317-4741
Author Rowland Kao, 0000-0003-0919-6401
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Collected From Edinburgh Research Explorer; PubMed Central; ORCID; UnpayWall; DOAJ-Articles; Crossref; Microsoft Academic Graph; CORE (RIOXX-UK Aggregator)
Hosted By Europe PubMed Central; Edinburgh Research Explorer; PLoS ONE; Enlighten; LSHTM Research Online
Publication Date 2012-03-07
Publisher Public Library of Science
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Country United Kingdom
Format application/pdf
Language English
Resource Type Article
keyword Biochemistry, Genetics and Molecular Biology_all_
keyword Q
keyword R
keyword keywords.General Biochemistry, Genetics and Molecular Biology
keyword Research Support, Non-U.S. Gov't
system:type publication
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Source https://science-innovation-policy.openaire.eu/search/publication?articleId=dedup_wf_001::f347c4de872233d5cb1819e165250df4
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Last Updated 23 December 2020, 12:03 (CET)
Created 23 December 2020, 12:03 (CET)