Background Whole genome sequencing (WGS) is increasingly used for pathogen identification and surveillance. Aim We evaluated costs and benefits of routine WGS through case studies at eight reference laboratories in Europe and the Americas which conduct pathogen surveillance for avian influenza (two laboratories), human influenza (one laboratory) and food-borne pathogens (five laboratories). Methods The evaluation focused on the institutional perspective, i.e. the ‘investment case’ for implementing WGS compared with conventional methods, based on costs and benefits during a defined reference period, mostly covering at least part of 2017. A break-even analysis estimated the number of cases of illness (for the example of Salmonella surveillance) that would need to be avoided through WGS in order to ‘break even’ on costs. Results On a per-sample basis, WGS was between 1.2 and 4.3 times more expensive than routine conventional methods. However, WGS brought major benefits for pathogen identification and surveillance, substantially changing laboratory workflows, analytical processes and outbreaks detection and control. Between 0.2% and 1.1% (on average 0.7%) of reported salmonellosis cases would need to be prevented to break even with respect to the additional costs of WGS. Conclusions Even at cost levels documented here, WGS provides a level of additional information that more than balances the additional costs if used effectively. The substantial cost differences for WGS between reference laboratories were due to economies of scale, degree of automation, sequencing technology used and institutional discounts for equipment and consumables, as well as the extent to which sequencers are used at full capacity.
Despite technological developments and regulatory improvements, most actors in the insect sector still face many challenges and uncertainties. While previous research mainly focused on the perception of domain-specific challenges and risks or has been limited to specific stages in the supply chain, this study aims to determine how stakeholders perceive the importance of past barriers and future risks along European insect supply chains, and to identify the applied risk management strategies. Data were collected from stakeholders across four stages of the supply chain (rearers (n=23), processors (n=8), and insect derived feed (n=14), and food (n=12) producers) through an online survey. In total, 60 different barriers and risks, as well as 20 different risk management strategies, were evaluated. We find that stakeholders across all stages of the supply chain perceived ‘financial, cost and market’ barriers and risks as most important, specifically referring to the lack of financial investments and price and demand uncertainties. In addition, legal restrictions were perceived to constrain upscaling opportunities across all supply chain stages. Worker and food safety barriers were generally perceived as least important. The main risk management strategies across all stages of the supply chain related to investments in technologies enhancing stability of both the quality and the quantity of insects and derived products. Stakeholders were most optimistic about the future reduction of ‘operational’ and ‘financial, cost and market’ risks. To further stimulate upscaling of the sector, we recommend to enhance financing opportunities, and to improve authorisations for the use of different substrates and the production of a wider set of insect-based ingredients for feed and food products.
Analysing the genomic data of pathogens with the help of next-generation sequencing (NGS) is an increasingly important part of disease outbreak investigations and helps guide responses. While this technology has already been successfully employed to elucidate and control disease outbreaks, wider implementation of NGS also depends on its cost-effectiveness. COMPARE - short for 'Collaborative Management Platform for detection and Analyses of (Re-) emerging and foodborne outbreaks' - is a major project, funded by the European Union, to develop a global platform for sharing and analysing NGS data and thereby improve the rapid identification, containment and mitigation of emerging infectious diseases and foodborne outbreaks. This article introduces the project and presents the results of a review of the literature, composed of previous relevant cost-benefit and cost-effectiveness analyses. The authors also outline the implications for a methodological framework to assess the costeffectiveness of COMPARE and similar systems.
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