Retrospective cost-utility analysis of the Non-typhoidal Salmonella control programme in Hungary

• Published in: Food control Vol. 120; p. 107529
• Main Authors: Országh, Erika, Pitter, János György, Kaló, Zoltán, Vokó, Zoltán, Józwiak, Ákos
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.02.2021
• Subjects: control methods; cost effectiveness; cost of illness analysis; Cost-utility analysis; demographic statistics; European Union; Food control; food safety; Foodborne disease; foodborne illness; Health technology assessment; humans; Hungary; incidence; mortality; pathogens; population; QALY; quality-adjusted life year; Salmonella Enteritidis; Salmonella spp; Salmonella Typhimurium; salmonellosis; serotypes; technology; zoonoses; Hungary; QALY; Foodborne disease; Health technology assessment; Cost-utility analysis; Salmonella spp; Food control
• ISSN: 0956-7135; 1873-7129
• DOI: 10.1016/j.foodcont.2020.107529

Salmonellosis is one of the most important foodborne infections in the European Union (EU), causing more than 90,000 human salmonellosis cases with an overall economic burden of 3 billion Euro annually (EFSA, 2014). Salmonella enterica serovar Enteritidis (S. Enteritidis or SE) and Salmonella enterica serovar Typhimurium (S. Typhimurium or ST) are the most pathogenic serotypes, also the most frequently reported serovars in humans in the EU. To fight against zoonotic diseases, including Salmonella, the EU established an extended control programme (Regulation (EC) No 2160/2003) that was launched in 2007. The cost-effectiveness of the control programme has not been examined at EU-level and there are only a limited number of national assessments available in the subject. The authors of the present paper conducted a retrospective cost-utility analysis of the Hungarian Salmonella Control Programme (HSCP) for the years 2007–2017. Costs and outcomes were considered from the state's perspective. Country-specific cost of illness estimates and a quality-adjusted life year (QALY) -based burden estimate have been developed for human salmonellosis cases. The programme's results were compared to a reference arm where incidence, hospitalization and mortality rates were extrapolated after 2007 by adjusting for the slight annual changes in population demographics, as if no control measures had been introduced in Hungary. The incremental cost-effectiveness ratio (ICER) was calculated and compared to the national health technology assessment (HTA) threshold, defined as 3xGDP per capita (EMMI, 2017). Since the calculated ICER value (27,150 EUR/QALY gain) was below the threshold (35,790 EUR/QALY gain), the HSCP was found to be cost-effective for the investigated time period. The analysis can serve as a model to carry out further analyses in relation to other pathogens or interventions and help the priority setting and decision-making processes of food safety in Hungary. Further discussion is needed on methodological questions, such as the perspective of the analysis or the inclusion or exclusion of various cost types. •Application of health technology assessment methodology in the field of food safety.•Calculation of country-specific cost of illness and health burden estimates.•a new approach for assessing the cost-effectiveness of a food safety intervention.•The aim is to support the food safety managers and policy makers.•Further discussion is needed on the application of the methodology.