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Drug Res (Stuttg) 2018; 68(02): 89-99
DOI: 10.1055/s-0043-119793
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Benefit-Cost Analysis of Radiocesium Decorporation by a Prussian Blue Treatment and Stockpiling

Alexis Rump
1   Bundeswehr Institute of Radiobiology, Munich, Germany
,
Daniela Stricklin
2   Applied Research Associates Inc., Arlington, USA
,
Andreas Lamkowski
1   Bundeswehr Institute of Radiobiology, Munich, Germany
,
Stefan Eder
1   Bundeswehr Institute of Radiobiology, Munich, Germany
,
Matthias Port
1   Bundeswehr Institute of Radiobiology, Munich, Germany
› Author Affiliations
Further Information

Publication History

received 08 May 2017

accepted 14 August 2017

Publication Date:
16 October 2017 (online)

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Abstract

In the case of an attack by a “dirty bomb” with cesium-137 there is a risk of internal contamination. The excretion of cesium-137 can be enhanced by Prussian Blue (PB), and thus the committed effective dose be reduced. We analyzed the benefit and costs of PB decorporation treatment. We simulated the reduction of the radiological dose by PB treatment after cesium-137 incorporation by inhalation. The saving of life time was quantified using the monetary “value of a statistical life” (VSL). Treatment costs were based on the market price of PB in Germany. Moreover we considered the holding costs of stockpiling. The benefit of PB treatment increases with its duration up to about 90 days. If treatment initiation is delayed, the maximum achievable benefit is decreased. For a VSL of 1.646 million €, the net benefit of a 90-days treatment started 1 day after the incorporation remains positive up to a stockpiling duration of 10 years. If starting PB treatment as late as the 180th day after incorporation, the costs will surpass the benefit. We conclude that a prompt decision making and early treatment initiation greatly impacts on the medical but also economic efficiency of a PB treatment.

Key words

benefit-cost analysis - pharmacoeconomics - radiological emergency - radionuclide incorporation - decorporation treatment - cesium - Prussian blue
 

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