Eflornithine is a cost-effective alternative to melarsoprol for the treatment of second-stage human West African trypanosomiasis in Caxito, Angola.

Hdl Handle:
http://hdl.handle.net/10144/26732
Title:
Eflornithine is a cost-effective alternative to melarsoprol for the treatment of second-stage human West African trypanosomiasis in Caxito, Angola.
Authors:
Robays, J; Raguenaud, M E; Josenando, T; Boelaert, M
Journal:
Tropical Medicine & International Health
Abstract:
OBJECTIVE: To compare the cost-effectiveness of eflornithine and melarsoprol in the treatment of human African trypanosomiasis. METHOD: We used data from a Médecins Sans Frontières treatment project in Caxito, Angola to do a formal cost-effectiveness analysis, comparing the efficiency of an eflornithine-based approach with melarsoprol. Endpoints calculated were: cost per death avoided; incremental cost per additional life saved; cost per years of life lost (YLL) averted; incremental cost per YLL averted. Sensitivity analysis was done for all parameters for which uncertainty existed over the plausible range. We did an analysis with and without cost of trypanocidal drugs included. RESULTS: Effectiveness was 95.6% for melarsoprol and 98.7% for eflornithine. Cost/patient was 504.6 for melarsoprol and 552.3 for eflornithine, cost per life saved was 527.5 USD for melarsoprol and 559.8 USD for eflornithine without cost of trypanocidal drugs but it increases to 600.4 USD and 844.6 USD per patient saved and 627.6 USD and 856.1 USD per life saved when cost of trypanocidal drugs are included. Incremental cost-effectiveness ratio is 1596 USD per additional life saved and 58 USD per additional life year saved in the baseline scenario without cost of trypanocidal drugs but it increases to 8169 USD per additional life saved and 299 USD per additional life year saved if costs of trypanocidal drugs are included. CONCLUSION: Eflornithine saves more lives than melarsoprol, but melarsoprol is slightly more cost-effective. Switching from melarsoprol to eflornithine can be considered as a cost-effective option according to the WHO choice criteria.
Affiliation:
Institute of Tropical Medicine, Antwerp, Belgium. Medecins Sans Frontieres Belgium. National Sleeping Sickness control program of Angola
Issue Date:
Feb-2008
URI:
http://hdl.handle.net/10144/26732
DOI:
10.1111/j.1365-3156.2007.01999.x
PubMed ID:
18304274
Additional Links:
http://www.blackwell-synergy.com/loi/tmi
Submitted date:
2008-05-19
Type:
Article
Language:
en
ISSN:
1365-3156
Appears in Collections:
Trypanosomiasis/Sleeping Sickness

Full metadata record

DC FieldValue Language
dc.contributor.authorRobays, J-
dc.contributor.authorRaguenaud, M E-
dc.contributor.authorJosenando, T-
dc.contributor.authorBoelaert, M-
dc.date.accessioned2008-05-19T09:33:52Z-
dc.date.available2008-05-19T09:33:52Z-
dc.date.issued2008-02-
dc.date.submitted2008-05-19-
dc.identifier.citationEflornithine is a cost-effective alternative to melarsoprol for the treatment of second-stage human West African trypanosomiasis in Caxito, Angola. 2008, 13 (2):265-71 Trop. Med. Int. Healthen
dc.identifier.issn1365-3156-
dc.identifier.pmid18304274-
dc.identifier.doi10.1111/j.1365-3156.2007.01999.x-
dc.identifier.urihttp://hdl.handle.net/10144/26732-
dc.description.abstractOBJECTIVE: To compare the cost-effectiveness of eflornithine and melarsoprol in the treatment of human African trypanosomiasis. METHOD: We used data from a Médecins Sans Frontières treatment project in Caxito, Angola to do a formal cost-effectiveness analysis, comparing the efficiency of an eflornithine-based approach with melarsoprol. Endpoints calculated were: cost per death avoided; incremental cost per additional life saved; cost per years of life lost (YLL) averted; incremental cost per YLL averted. Sensitivity analysis was done for all parameters for which uncertainty existed over the plausible range. We did an analysis with and without cost of trypanocidal drugs included. RESULTS: Effectiveness was 95.6% for melarsoprol and 98.7% for eflornithine. Cost/patient was 504.6 for melarsoprol and 552.3 for eflornithine, cost per life saved was 527.5 USD for melarsoprol and 559.8 USD for eflornithine without cost of trypanocidal drugs but it increases to 600.4 USD and 844.6 USD per patient saved and 627.6 USD and 856.1 USD per life saved when cost of trypanocidal drugs are included. Incremental cost-effectiveness ratio is 1596 USD per additional life saved and 58 USD per additional life year saved in the baseline scenario without cost of trypanocidal drugs but it increases to 8169 USD per additional life saved and 299 USD per additional life year saved if costs of trypanocidal drugs are included. CONCLUSION: Eflornithine saves more lives than melarsoprol, but melarsoprol is slightly more cost-effective. Switching from melarsoprol to eflornithine can be considered as a cost-effective option according to the WHO choice criteria.en
dc.language.isoenen
dc.relation.urlhttp://www.blackwell-synergy.com/loi/tmien
dc.rightsArchived on this site with the kind permission of Wiley-Blackwellen
dc.subject.meshAngolaen
dc.subject.meshCost of Illnessen
dc.subject.meshCost-Benefit Analysisen
dc.subject.meshEflornithineen
dc.subject.meshHumansen
dc.subject.meshMelarsoprolen
dc.subject.meshTreatment Outcomeen
dc.subject.meshTrypanocidal Agentsen
dc.subject.meshTrypanosomiasis, Africanen
dc.titleEflornithine is a cost-effective alternative to melarsoprol for the treatment of second-stage human West African trypanosomiasis in Caxito, Angola.en
dc.typeArticleen
dc.contributor.departmentInstitute of Tropical Medicine, Antwerp, Belgium. Medecins Sans Frontieres Belgium. National Sleeping Sickness control program of Angolaen
dc.identifier.journalTropical Medicine & International Healthen

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