title: Alveolar echinococcosis: from a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years.
abstract: Alveolar echinococcosis (AE) is a serious liver disease. The aim of this study was to explore the long-term prognosis of AE patients, the burden of this disease in Switzerland and the cost-effectiveness of treatment.
  
  
  
  Relative survival analysis was undertaken using a national database with 329 patient records. 155 representative cases had sufficient details regarding treatment costs and patient outcome to estimate the financial implications and treatment costs of AE.
  
  
  
  For an average 54-year-old patient diagnosed with AE in 1970 the life expectancy was estimated to be reduced by 18.2 and 21.3 years for men and women, respectively. By 2005 this was reduced to approximately 3.5 and 2.6 years, respectively. Patients undergoing radical surgery had a better outcome, whereas the older patients had a poorer prognosis than the younger patients. Costs amount to approximately Euro108,762 per patient. Assuming the improved life expectancy of AE patients is due to modern treatment the cost per disability-adjusted life years (DALY) saved is approximately Euro6,032.
  
  
  
  Current treatments have substantially improved the prognosis of AE patients compared to the 1970s. The cost per DALY saved is low compared to the average national annual income. Hence, AE treatment is highly cost-effective in Switzerland.
authors.affiliation: Institute of Parasitology, University of Zürich, CH-8057 Zürich, Switzerland.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Torgerson
authors.forename: Alexander
authors.initials: A
authors.lastname: Schweiger
authors.forename: Peter
authors.initials: P
authors.lastname: Deplazes
authors.forename: Maja
authors.initials: M
authors.lastname: Pohar
authors.forename: Jürg
authors.initials: J
authors.lastname: Reichen
authors.forename: Rudolf W
authors.initials: RW
authors.lastname: Ammann
authors.forename: Philip E
authors.initials: PE
authors.lastname: Tarr
authors.forename: Nerman
authors.initials: N
authors.lastname: Halkic
authors.forename: Beat
authors.initials: B
authors.lastname: Müllhaupt
mesh_terms: D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D002908:Chronic Disease; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D004444:Echinococcosis, Hepatic / Q000188:drug therapy / Q000191:economics* / Q000401:mortality* / Q000601:surgery; D019353:Endemic Diseases / Q000191:economics; D005260:Female; D005589:Foxes; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D013557:Switzerland / Q000453:epidemiology; D015047:Zoonoses / Q000453:epidemiology / Q000469:parasitology
chemical_list: D000871:Anthelmintics