# Presentation: 330208

## Economic Analysis of the 2002 WNV Epidemic in Louisiana

**Armineh Zohrabian, Martin Meltzer, **
**Lyle Petersen, James Sejvar, Raoult Ratard**

## Objectives

**Describe the costs of the epidemic**
**Provide a framework for estimating expected benefits from prevention and control**

## Background

**June to December 2002 WNV epidemic in LA**
**329 total cases **
**214 treated as inpatient **
**24 deceased**
**Cases occurred in 41 parishes out of 64**

## Background

**15 parishes had mosquito abatement and surveillance programs in 2002 **
**7 parishes had only mosquito abatement programs**

***(continued)***

## Cost of Epidemic

**Indirect medical costs and productivity losses**
**Direct medical costs**
**Inpatient**
**Outpatient**
**Costs incurred by public health offices and other government agencies**
**Costs of LOPH**
**Costs of mosquito control**

## Direct Medical Charges*

**Charges for 21 inpatient cases****	****$1,088,353**
**Maximum charges per patient****	**** $242,609**
**Minimum charges****	****$2,019**
**Average charges ****	****$51,826**
**Estimated total for 214 cases ****	****$11,090,800**
***21 inpatient cases analyzed to date.**

## Direct Costs of Illness

**Cost-to-charge ratio for Louisiana is 0.51.**
**Total economic costs for 214 inpatient cases = $5.5 million**

## Cost of Vector Control 

**$5 million state reimbursement request for WNV vector control expenses from 93 entities **
**Actual vector control costs higher**
**Reimbursement not requested for all incurred costs**
**In-kind payments not included**
**Expenses after August 23 not included**

## Cost of Vector Control

**Requested to total expenses ratio is**
**	****1 : 3.5 (estimated).**
**$17.5 million total expenses (estimated)**

***(continued)***

## Louisiana OPH

**$885,914 (estimated) state WNV expenses, June-November 2002 **
**$585,914 basic operating expenses**
** ****$166,000 contracts such as LSU vet. diagnostic lab, contract entomologist**
**$134,000 laboratory**

## Summary costs (provisional) 

|  | millions |
| --- | --- |
| Direct medical costs |  |
| Inpatient | 	$5.5 |
| Outpatient | to be determined |
| Indirect medical costs | to be determined |
| Public offices |  |
| Mosquito control | 	$17.5 |
| LOPH 
 | 	$0.9
 |
| Total
Total per capita | 	>	$24 million
 	>	$5.5 |
|  |  |

- Summary costs (provisional)

## Inpatient Costs for the US, 2002

**Total WNV cases in US: ****	****4007**
**Assume 65% inpatient, $26,431 per patient cost (LA example)**
**Provisional estimates $ 69 million WNV *****inpatient***** costs**

## Future Research

**Expected benefits equal to the product of:**
**Probability of WN epidemic**
**% reduction in cases due to prevention and control **
**Cost of epidemics without prevention and control**

## Conclusions

**Based on provisional data, *****epidemic costs***** in LA are over $24 million**
**Extrapolating to national level, only *****direct costs for inpatient***** treatment $69 million**
**Complete economic analysis under way**
**Do costs of epidemic justify investments in development of therapeutics and vaccines?**

## Acknowledgements

**Staff of LOPH **
**Medical directors, administrators, and staff of OPH  Regional Offices **
**Hospitals that provided inpatient charges **
**Staff of Louisiana Office of Emergency Preparedness**
**Staff of mosquito control and abatement programs**
**Kakoli Roy, Doug Scott, Kaafee Billah, Roger Nasci, Roy Campbell, Emily Zielinski, Marcia Gray and Anna Jimenez of CDC, and Jeannine Pia.**