Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

OBJECTIVES: To assess the cost-effectiveness of current monotherapies and prospective combinations for treating visceral leishmaniasis (VL) in Bihar, India in terms of years of life lost (YLL) averted as well as deaths averted. METHODS: We employed two methods to estimate the number of avertable deaths in our analysis: one using estimated mortality, the other using direct incidence estimates for VL. Costs of care are based on an average private hospital in Bihar, and data on drug costs were obtained both locally and from the World Health Organization. RESULTS: The cost of monotherapies per averted YLL ranged from US$2 for paromomycin in an outpatient setting to US$20-22 for AmBisome at 20 mg/kg. The corresponding costs per death averted ranged from US$53-54 to US$523-527. Combinations ranged US$5-8 per YLL averted and US$124-213 per death averted. CONCLUSION: The available treatments for VL are cost-effective, and our mortality and incidence-based methods produce consistent estimates. The combinations considered here were more cost-effective than most monotherapies. Having multiple treatment options and combining drugs are also likely to reduce drug pressure and prolong the drugs' life-span of effective use.

Original publication

DOI

10.1111/j.1365-3156.2009.02306.x

Type

Journal

Tropical medicine & international health : TM & IH

Publication Date

08/2009

Volume

14

Pages

918 - 925

Addresses

UNICEF/UNDP/WB/WHO Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland. olliarop@who.int

Keywords

Humans, Leishmaniasis, Visceral, Phosphorylcholine, Amphotericin B, Paromomycin, Antiprotozoal Agents, Drug Administration Schedule, Adolescent, Adult, Child, Cost-Benefit Analysis, Direct Service Costs, Drug Costs, Hospital Costs, India, Female, Male, Practice Guidelines as Topic, Young Adult