An ex-ante economic appraisal of Bluetongue virus incursions and control strategies

The incursion of Bluetongue disease into the UK and elsewhere in Northern Europe in 2008 raised concerns about maintaining an appropriate level of preparedness for the encroachment of exotic diseases as circumstances and risks change. Consequently the Scottish government commissioned the present study to inform policy on the specific threat of Bluetongue virus 8 (BTV8) incursion into Scotland. An interdisciplinary expert panel, including BTV and midge experts, agreed a range of feasible BTV incursion scenarios, patterns of disease spread and specific control strategies. The study was primarily desk-based, applying quantitative methodologies with existing models, where possible, and utilizing data already held by different members of the project team. The most likely distribution of the disease was explored given Scotland's agricultural systems, unique landscape and climate. Epidemiological and economic models are integrated in an ex-ante cost-benefit appraisal of successful prevention of hypothetical BTV8 incursion into Scotland under various feasible incursion scenarios identified by the interdisciplinary panel. The costs of current public and private surveillance efforts are compared to the benefits of the avoided losses of potential disease outbreaks. These avoided losses included the direct costs of alternative vaccination, protection zone (PZ) strategies and their influence on other costs arising from an outbreak as predicted by the epidemiological model. Benefit-cost ratios were ranked within each incursion scenario to evaluate alternative strategies. In all incursion scenarios, the ranking indicated that a strategy, including 100% vaccination within a PZ set at Scottish counties along the England-Scotland border yielded the least benefit in terms of the extent of avoided outbreak losses (per unit cost). The economically optimal vaccination strategy was the scenario that employed 50% vaccination and all Scotland as a PZ. The results provide an indicator of how resources can best be targeted for an efficient ex-ante control strategy.