OUCRU workshop on economic epidemiology

Maciek Boni Economic Epidemiology

On March 25-26, the OUCRU Mathematical Modeling Team hosted the TDModNet Workshop on Economic Epidemiology. The workshop brought together principal investigators, postdocs, and students from various Oxford overseas units who share interests in health economics, the integration of economic and epidemiological dynamics in disease systems, and how human behavior affects the dynamics of epidemics. The workshop was structured into four half-day sessions intended to encourage free-form discussion on various topics. The aim was to bring together individuals working in different research units and on different topics, to share common areas of interest in economic epidemiology.

Maciej Boni ran sessions on the economics of disease eradication through vaccination, and on the microeconomic incentives smallholder poultry farmers balance when considering the risk of avian influenza outbreaks. These discussions were meant to look at the incentives present in public health programs and how these incentives might change through time, especially during the course of an outbreak or epidemic. One classic example of this problem is how demand for a vaccine drops as a vaccination campaign achieves more success — vaccination campaigns can be victims of their own success if the public begins to perceive lower risks and reduces its vaccine uptake.

Ben Cooper led a session on the cost-effectiveness of influenza vaccination in Thailand, and how Bayesian methods can be used to analyze the uncertainty in certain age-targeted strategies. An important concept in the economics of vaccination is how the direct and indirect benefits of vaccination are accounted for in health economic analyses. Vaccinating younger age groups such as schoolchildren may have more indirect benefits as schoolchildren are more likely than other age groups to infect a large number of secondary contacts. Ben led a practical session with WinBUGS showing how analyses are designed and carried out for these types of problems.

Yoel Lubell led a discussion on the health economics of point-of-case diagnostics. The most important use of point-of-care diagnostics is to determine appropriate treatment and case management for the patient. However, diagnostics are imperfect, yielding both false positive and false negative results, and their use must be planned appropriately taking into account the potential negative externalities of misdiagnosis. False positive results may be more worrying in an epidemiological context where disease control and program costs are priorities. But, false negatives will be the main concern in an elimination setting. In addition, misdiagnosis may have unexpected results on appropriate treatment and drug resistance evolution, which would have impacts on long-term societal costs and health outcomes.

The workshop concluded with PhD students sharing their project updates with one another. Thanks to all for their participation! Please remember to check the TDModNet website for updates on when student travel fellowships will be offered.