Eflornithine is a cost-effective alternative to melarsoprol for the treatment of second-stage human West African trypanosomiasis in Caxito, Angola.
Name:
Eflornithine is a cost-effective ...
Size:
148.1Kb
Format:
PDF
Description:
main article
Affiliation
Institute of Tropical Medicine, Antwerp, Belgium. Medecins Sans Frontieres Belgium. National Sleeping Sickness control program of AngolaIssue Date
2008-02Submitted date
2008-05-19
Metadata
Show full item recordAbstract
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.PubMed ID
18304274Additional Links
http://www.blackwell-synergy.com/loi/tmiType
ArticleLanguage
enISSN
1365-3156ae974a485f413a2113503eed53cd6c53
10.1111/j.1365-3156.2007.01999.x
Scopus Count
Collections
Related articles
- Cost-effectiveness analysis of alternative treatments of African gambiense trypanosomiasis in Uganda.
- Authors: Politi C, Carrín G, Evans D, Kuzoe FA, Cattand PD
- Issue date: 1995 Jul-Aug
- Effectiveness of melarsoprol and eflornithine as first-line regimens for gambiense sleeping sickness in nine Médecins Sans Frontières programmes.
- Authors: Balasegaram M, Young H, Chappuis F, Priotto G, Raguenaud ME, Checchi F
- Issue date: 2009 Mar
- Update on field use of the available drugs for the chemotherapy of human African trypanosomiasis.
- Authors: Simarro PP, Franco J, Diarra A, Postigo JA, Jannin J
- Issue date: 2012 Jun
- Eflornithine is safer than melarsoprol for the treatment of second-stage Trypanosoma brucei gambiense human African trypanosomiasis.
- Authors: Chappuis F, Udayraj N, Stietenroth K, Meussen A, Bovier PA
- Issue date: 2005 Sep 1
- Melarsoprol versus eflornithine for treating late-stage Gambian trypanosomiasis in the Republic of the Congo.
- Authors: Balasegaram M, Harris S, Checchi F, Ghorashian S, Hamel C, Karunakara U
- Issue date: 2006 Oct