Traditional versus hazard analysis and critical control point-based inspection: results from a poultry slaughter project.

Federal meat and poultry inspection has changed little since the Federal Meat Inspection Act was passed in 1906, followed by the Poultry Products Inspection Act of 1957 and related amendments. These acts mandate sensory or organoleptic (sight, smell, and touch) inspection of all carcasses. For several decades, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) has been urged by various organizations to move to a scientific, risk-based inspection system. In partial response to these calls, the FSIS has developed new slaughter inspection models that are currently being tested with volunteer plants in the hazard analysis and critical control point (HACCP)-based inspection models project. To evaluate whether plants operating under the new inspection models perform at least as well as they did under the current or traditional system, microbial and organoleptic data are being collected before and after the implementation of the new inspection models. In this article, we describe the baseline and models data collection procedures and present the results of the baseline and models data collection for eight plants that slaughter young chickens. The results from the first eight volunteer plants suggest that inspection under the new models is equivalent and in some ways superior to that of traditional inspection. This pilot project suggests that new slaughter inspection systems, which rely on HACCP principles with FSIS oversight and verification services, can maintain or even improve food safety and other consumer protection conditions relative to traditional hands-on inspection methods.

Cost effectiveness of zanamivir for the treatment of influenza in a high risk population in Australia.

OBJECTIVE: To use data from a clinical trial of zanamivir, a new antiviral drug, to estimate the costs and effectiveness of alternative treatment strategies for a high-risk population in Australia visiting a physician for treatment of influenza or influenza-like illness within 36 hours of symptom onset. DESIGN AND SETTING: This was a modelling study using data from a randomised, double-blind, placebo-controlled trial with centres in Australia, New Zealand and South Africa. Cost data were taken from standard Australian sources. METHODS: Efficacy data from the clinical trial were used to populate a computer model designed to estimate the costs and health outcomes associated with alternative treatments for influenza and influenza-like illness. Only patients who consulted the physician within 36 hours of symptom onset were included in this trial. Cost data were used to translate the clinical data into treatment cost estimates. RESULTS: Treatment with zanamivir for this high risk population results in an incremental cost of $A14.20 per day of symptoms avoided in the base case. The cost per quality-adjusted life-year (QALY) gained is $A11,715. The results are sensitive to several parameter values, including the influenza-positive rate and the impact of zanamivir on days to alleviate symptoms and hospitalisation. CONCLUSIONS: Influenza is costly for the high risk population who seek physician treatment. Treatment with zanamivir for this population is cost effective based on an $A78,000 per QALY benchmark. Zanamivir could be cost saving if it reduces the hospitalisation rate.

Estimating the willingness to pay for drug abuse treatment: a pilot study.

Previous economic studies of the benefits of drug treatment have limited their estimation to tangible benefits, and thus have underestimated the benefits of drug treatment. The willingness-to-pay (WTP) approach is a more encompassing benefit valuation method that captures both tangible and intangible benefits and accords with valuation concepts used by economists. In this study, we report the results of a pilot study in which we used the contingent valuation (CV) method to value drug treatment. We conducted mall intercept surveys in two communities: the Triad area in North Carolina and Brooklyn, New York. We estimated WTP models for two different drug treatment programs: a program for all drug users and a program specifically targeted to women drug users. We modeled respondents' WTP for drug treatment as a function of their demographics and to responses from attitudinal/experience questions. The mean WTP for both types of drug treatment programs was estimated to be approximately $37 per respondent. Finally, we demonstrated how the results of the CV method may be used in a benefit-cost analysis of drug treatment.

A pharmacoeconomic model for the treatment of influenza.

OBJECTIVE: The aim of this study was to develop a generic treatment algorithm for influenza and influenza-like illness (ILI) that could be used to estimate the costs and outcomes of current and new treatments for influenza in different countries for different patient subgroups. METHODS: A series of possible treatment pathways was identified and the probabilities of different patient subgroups following each pathway were estimated by using the published literature. The health outcomes and health service use and unit costs for each pathway were estimated from trial data and standard data sources. An interactive computer model was created, the base-case input parameter values were assigned, and estimates of the current costs of influenza and ILI in different population subgroups estimated. Sensitivity analyses were performed by changing input parameter values. RESULTS: The average healthcare cost of influenza and ILI per person in the US was $US72 for the general population and $US330 for a high risk population (1997 values). The average total cost per patient (healthcare cost plus productivity losses) was $US320 for the general population and $US546 for a high risk population. These costs are sensitive to changes in the proportion of patients visiting a physician and to the proportion of patients hospitalised with complications of the disease. Days to alleviate major symptoms and other health outcome measures are sensitive to the percentage of patients who receive antiviral therapy as well as to the efficacy of this therapy. CONCLUSIONS: The costs and health outcomes of influenza and ILI depend on the extent to which patients visit a physician, the use of antiviral drugs, and the incidence of complications requiring hospital care. The computer model will allow decision-makers to assess the cost effectiveness and the potential budget impact of new antivirals for treating influenza.