Current incidence, treatment costs and seasonality of pinkeye in Australian cattle estimated from sales of three popular medications.

Pinkeye is an economically important ocular disease occurring in all cattle producing areas of Australia. This study was undertaken to estimate the frequency of occurrence of the disease in Australia and treatment costs of the disease to the cattle industry using the sales of popular pinkeye medications as a surrogate indicator. Monthly sales data for Orbenin® Eye Ointment, Opticlox® Eye Ointment and Terramycin® Pinkeye Aerosol were analysed. We first estimated the number of cattle that can be treated with a syringe or a can and then using the data of sales of these pinkeye medications and the total cattle population of Australia, estimated the incidence of pinkeye. Probability distributions were used to include uncertainty around the estimates. Costs to producers were estimated based on retail prices of these medications. The results indicated that 732,864 syringes of Orbenin® Eye Ointment, 134,800 syringes of Opticlox® Eye Ointment and 27,755 cans of Terramycin® Pinkeye Aerosol are sold in Australia per year. Based on some assumptions of the number of cases treated by these drugs and number of cases left untreated, the number of cattle affected by pinkeye each year in Australia was estimated to be 2.80 million (95 % PI: 1.76, 4.65) or 10.25 % (95 % PI: 6.43, 16.97) of the entire Australian cattle herd. The cattle industry is expected to lose AU$ 9.67 million (95 % PI: 8.56, 13.11) each year just considering the cost of these three drugs. The results suggest that losses due to pinkeye in the Australian cattle industry are considerably higher than previously thought and should be used to inform the development of disease prevention and control policies.

New vaccines against otitis media: projected benefits and cost-effectiveness.

OBJECTIVE: New vaccines that offer protection against otitis media caused by nontypeable Haemophilus influenzae and by Moraxella catarrhalis are under development. However, the potential health benefits and economic effects of such candidate vaccines have not been systematically assessed. METHODS: We created a computerized model to compare the projected benefits and costs of (1) the currently available 7-valent pneumococcal conjugate vaccine, (2) a candidate pneumococcal-nontypeable H influenzae vaccine that has been tested in Europe, (3) a hypothetical pneumococcal-nontypeable H influenzae-Moraxella vaccine, and (4) no vaccination. The clinical probabilities of acute otitis media and of otitis media with effusion were generated from multivariate analyses of data from 2 large health maintenance organizations and from the Pittsburgh Child Development/Otitis Media Study cohort. Other probabilities, costs, and quality-of-life values were derived from published and unpublished sources. The base-case analysis assumed vaccine dose costs of $65 for the 7-valent pneumococcal conjugate vaccine, $100 for the pneumococcal-nontypeable H influenzae vaccine, and $125 for the pneumococcal-nontypeable H influenzae-Moraxella vaccine. RESULTS: With no vaccination, we projected that 13.7 million episodes of acute otitis media would occur annually in US children aged 0 to 4 years, at an annual cost of $3.8 billion. The 7-valent pneumococcal conjugate vaccine was projected to prevent 878,000 acute otitis media episodes, or 6.4% of those that would occur with no vaccination; the corresponding value for the pneumococcal-nontypeable H influenzae vaccine was 3.7 million (27%) and for the pneumococcal-nontypeable H influenzae-Moraxella vaccine was 4.2 million (31%). Using the base-case vaccine costs, pneumococcal-nontypeable H influenzae vaccine use would result in net savings compared with nontypeable 7-valent pneumococcal conjugate use. Conversely, pneumococcal-nontypeable H influenzae-Moraxella vaccine use would not result in savings compared with pneumococcal-nontypeable H influenzae vaccine use, but would cost $48 000 more per quality-adjusted life-year saved. The results were sensitive to variations in assumptions on vaccine effectiveness and vaccine dose costs but not to variations in other assumptions. CONCLUSIONS: New candidate vaccines against otitis media have the potential to prevent millions of disease episodes in the United States annually. If priced comparably with other recently introduced vaccines, these new otitis vaccines could achieve cost-effectiveness comparable with or more favorable than that of the 7-valent pneumococcal conjugate vaccine.