Modeling uncertainty for economic effects of echinococcosis were used initially in studies in Tunisia and Jordan (Majorowski et al., 2005; Torgerson et al., 2001). This has many advantages, most notably surveillance data from which the costs of the disease can be calculated are not deterministic and depend, interalia upon sampling error, errors due to diagnosis and problems with bias and underreporting. For financial costs there will be uncertainty in the mean cost of treatment due to large variations in the treatment costs of individual patients. In developing the DALY there is also uncertainty in terms of morbidity and mortality. In the Tibetan study (Budke et al., 2004), the DALY for AE was developed, with disability outcomes divided into five components (cured, improved, stable, worse, or death) based on the health survey as well as findings from past studies where albendazole was utilized as the sole treatment for human AE. To model uncertainty, Monte-Carlo techniques were employed. From published data, the results of chemotherapeutic treatment of 103 AE patients were used to construct a multinomial distribution for the likely outcome of treatment. Of these 103 subjects, there was an approximate probability of 4% of cure resulting from calcification and regression of the lesions. Patients in this category were assigned a disability weight of 0.200 for 5 years. A probability of approximately 27% was given for having mild disease with disability weight 0.200, a probability of approximately 41% was given for having disease equated to a disability weight of 0.239, and a probability of approximately 22% was given for severe disease equating to a disability weight 0.809. Patients assigned to these three later disease states were pr...
... middle of paper ...
... AE in Switzerland has been estimated to be approximately 77 DALYs at a cost of at least $3 million per annum (Torgerson et al., 2008). The huge differences between Switzerland and Shiqu county are of course due to the much high incidence in Shiqu and the very limited treatment options. In Switzerland, although it is an emerging disease (Schweiger et al., 2007) with an increasing incidence, the incidence is still low and modern but expensive treatment methods, not available in Shiqu, have dramatically improved the life expectancy of AE and hence the YLL is quite small. However, the financial costs in Switzerland are higher even though the burden of DALYs is much lower. This is due to the very high treatment costs and high salaries enjoyed by Swiss residents and illustrates the complexities and problems of reliance on a purely financial approach to burden analysis.