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    Jan 26, 2021
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    Eflornithine is a cost-effective alternative to melarsoprol for the treatment of second-stage human West African trypanosomiasis in Caxito, Angola.

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    Authors
    Robays, J
    Raguenaud, M E
    Josenando, T
    Boelaert, M
    Affiliation
    Institute of Tropical Medicine, Antwerp, Belgium. Medecins Sans Frontieres Belgium. National Sleeping Sickness control program of Angola
    Issue Date
    2008-02
    Submitted date
    2008-05-19
    
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    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.
    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
    Type
    Article
    Language
    en
    ISSN
    1365-3156
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1365-3156.2007.01999.x
    Scopus Count
    Collections
    Trypanosomiasis/Sleeping Sickness

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