Cost-effectiveness of liposomal amphotericin B in hospitalised patients with mucocutaneous leishmaniasis.

Abstract

OBJECTIVE:

To compare the cost-effectiveness of L-AmB with that of SbV and AmB-D, for the treatment of mucocutaneous leishmaniasis in a hospital in north-east Brazil.

METHODS:

We developed an economic model based on retrospective data of 73 hospitalised patients in 2006-2012, from hospital and public health system perspectives.

RESULTS:

In the economic model, 82.2% of patients who started treatment with L-AmB had completed it after 2 months, vs. 22.0% for the SbV and 19.9% for the AmB-D groups. After 12 months of follow-up, these proportions were 100% in the L-AmB, 77.4% in the AmB-D and 72.2% in the SbV group. Markov chain analyses showed that the group that started therapy with SbV had the lowest mean total cost (US$ 3782.38), followed by AmB-D (US$ 5211.27) and L-AmB (US$ 11 337.44). The incremental cost-effectiveness ratio for L-AmB was US$ 18 816.23 against SbV and US$ 24 504.65 against AmB-D. In the sensitivity analysis, the drug acquisition cost of L-AmB significantly influenced the results.

CONCLUSIONS:

In the treatment of mucocutaneous leishmaniasis, L-AmB is a cost-effective alternative to SbV and AmB-D owing to its higher effectiveness, safety and shorter course.

• Authors: Sóstenes Mistro, Bárbara Gomes, Lorena Rosa, Ligia Miranda, Marianne Camargo, Roberto Badaró
• Journal: Tropical medicine & international health : TM & IH (Trop Med Int Health) Vol. 22 Issue 12 Pg. 1569-1578 (12 2017) ISSN: 1365-3156 [Electronic] England
• PMID: 29078022 (Publication Type: Journal Article)
• Copyright: © 2017 John Wiley & Sons Ltd.

Chemical References

• Antiprotozoal Agents
• liposomal amphotericin B
• Amphotericin B

Topics

• Adult
• Aged
• Amphotericin B (economics, therapeutic use)
• Antiprotozoal Agents (economics, therapeutic use)
• Brazil
• Cost-Benefit Analysis
• Drug Costs
• Female
• Hospitalization
• Humans
• Leishmania braziliensis
• Leishmaniasis, Mucocutaneous (drug therapy, economics)
• Male
• Middle Aged
• Models, Economic