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Related Experiment Video

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Murine Model of Allergen Induced Asthma
08:05

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Published on: May 14, 2012

Surveillance for isocyanate asthma: a model based cost effectiveness analysis.

D M Wild1, C A Redlich, A D Paltiel

  • 1Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA.

Occupational and Environmental Medicine
|October 20, 2005
PubMed
Summary

Occupational surveillance for isocyanate asthma is cost-effective. Annual surveillance for isocyanate-induced asthma yields significant benefits, proving cost-effective from both employer and societal viewpoints.

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Area of Science:

  • Occupational Medicine
  • Health Economics
  • Epidemiology

Background:

  • Logistical and financial constraints limit large prospective cohort studies for occupational surveillance.
  • Decisions on surveillance often lack evidence on relative benefits and costs.
  • Isocyanate-induced asthma is the most common immune-mediated occupational asthma.

Purpose of the Study:

  • To develop a model-based approach for evaluating the costs and benefits of occupational surveillance.
  • To assess surveillance for isocyanate-induced asthma from employer and societal perspectives.
  • To compare annual surveillance with passive case finding strategies.

Main Methods:

  • A mathematical simulation model of isocyanate asthma was employed.
  • Compared annual surveillance versus passive case finding.
  • Outcome measures included quality-adjusted life years (QALYs), symptom-free days (SFDs), costs, and cost-effectiveness ratios (CER).

Main Results:

  • For 100,000 workers, surveillance prevented 683 disability cases over 10 years.
  • Employer perspective: CER of $24,000/QALY and $13.33/SFD.
  • Societal perspective: Surveillance was cost-saving.
  • Results were sensitive to sensitization, removal, and diagnosis times.

Conclusions:

  • The CER for isocyanate asthma surveillance falls within acceptable ranges.
  • Societal perspective offers a more attractive CER, indicating cost-sharing opportunities.
  • Model-based approach effectively evaluates surveillance cost-effectiveness for isocyanate asthma.
  • This modeling strategy can be applied to other occupational conditions.