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Volume 3, Number 2—June 1997
Perspective

The Economic Impact of a Bioterrorist Attack: Are Prevention and Postattack Intervention Programs Justifiable?

Arnold F. Kaufmann, Martin I. MeltzerComments to Author , and George P. Schmid
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Main Article

Table 5

Cost thresholdsa of interventions ($/person) by day of intervention initiation, prophylaxis effectiveness, and discount rates.

Threshold costs for intervention ($/person, multiplication factor of 15b)
Anthrax
 Tularemia
 Brucellosis
Post-attack dayd Disc. ratec
 Post-attack day Disc. rate
 Post-attack day Disc. rate
5% 3% 5% 3% 5% 3%
90% effectivenesse 80% effectivenesse 80% effectivenesse
0 9,838 14,238 0 1,891 2,633 0-7 233* 282*
1 8,851 12,809 1 1,873 2,609 8-14 224* 272*
2 7,022 10,162 2 1,599 2,227 15-28 211* 255*
3 3,775 5,463 3 756 1,053 29-56 179* 217*
4 1,893 2,739 4 258 366 57-112 86* 104*
5 944 1,366 5 79 110 113+ 24* 30*
6 468 677 6 20* 28
Prophylaxis costc $226 $28 $285
95% effectivenesse 95% effectivenesse
0 10,370 15,007 0 2,229 3,104 0-7 274 333
1 9,359 13,544 1 2,207 3,074 8-14 264 320
2 7,427 10,948 2 1,898 2,644 15-28 248 301
3 3,995 5,782 3 898 1,251 29-56 211 256
4 2,004 2,900 4 328 457 57-112 102* 124*
5 1,000 1,447 5 93* 131 113+ 29* 35*
6 496 718 6 23* 32*
Prophylaxis coste $238 $104 $161

*Threshold value is below estimated cost of prophylaxis.
aCost threshold is the point where cost of intervention and net savings due to the intervention are equal.
bMultiplication factor to adjust for persons who participated in the prophylaxis program but were unexposed.
cApplied to present value of expected future earnings and housekeeping services (weighted average for age and sex).
dPostattack day on which prophylaxis was effecively implemented.
eSee Table 2 for prophylaxis regimens assumed to give the stated levels of effectiveness and cost/person of prophylaxis.

Main Article

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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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