Abstract
In this paper, we examine the cost effectiveness of investment in personal protective equipment (PPE) for protecting health care workers (HCWs) against two infectious diseases: Ebola virus and methicillin-resistant Staphylococcus aureus (MRSA). This builds on similar work published for COVID-19 in 2020. We developed two separate decision-analytic models using a payer perspective to compare the costs and effects of multiple PPE use scenarios for protection of HCW against Ebola and MRSA. Bayesian multivariate sensitivity analyses were used to consider the uncertainty surrounding all key parameters for both diseases. We estimate the cost to provide adequate PPE for a HCW encounter with an Ebola patient is $13.04, which is associated with a 97% risk reduction in infections. The mean incremental cost-effectiveness ratio (ICER) is $3.98 per disability-adjusted life year (DALY) averted. Because of lowered infection and disability rates, this investment is estimated to save $132.27 in averted health systems costs, a financial ROI of 1,014%. For MRSA, the cost of adequate PPE for one HCW encounter is $0.88, which is associated with a 53% risk reduction in infections. The mean ICER is $362.14 per DALY averted. This investment is estimated to save $20.18 in averted health systems costs, a financial ROI of 2,294%. In terms of total health savings per death averted, investing in adequate PPE is the dominant strategy for Ebola and MRSA, suggesting that it is both more costly and less clinically optimal to not fully invest in PPE for these diseases. There are many compelling reasons to invest in PPE to protect HCWs. This analysis examines the economic case, building on previous evidence that protecting HCWs with PPE is cost-effective for COVD-19. Ebola and MRSA scenarios were selected to allow assessment of both endemic and epidemic infectious diseases. While PPE is cost-effective for both conditions, compared to our analysis for COVID-19, PPE is relatively more cost-effective for Ebola and relatively less so for MRSA. Further research is needed to assess shortfalls in the PPE supply chain identified during the COVID-19 pandemic to ensure an efficient and resilient supply in the face of future pandemics.
Publisher
Public Library of Science (PLoS)
Reference42 articles.
1. Transforming the medical PPE ecosystem: Joint action can protect healthcare workers with effective and high-quality personal protective equipment.;K Gandrup-Marino,2021
2. Cost-effectiveness and return on investment of protecting health workers in low- And middle-income countries during the COVID-19 pandemic.;N Risko;PLoS One.,2020
3. Examining the cost-effectiveness of personal protective equipment for formal healthcare workers in Kenya during the COVID-19 pandemic.;J Kazungu;BMC Health Serv Res.,2021
4. Cost-effectiveness of surgical mask, N-95 respirator, hand-hygiene and surgical mask with hand hygiene in the prevention of COVID-19: Cost effectiveness analysis from Indian context.;BS Bagepally;Clin Epidemiol Glob Heal.,2021
5. Spatiotemporal variability in case fatality ratios for the 2013–2016 Ebola epidemic in West Africa.;A Forna;Int J Infect Dis,2020