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Cost‐effectiveness analysis of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis
Author(s) -
CardonaArias Jaiberth Antonio,
LópezCarvajal Liliana,
Tamayo Plata Mery Patricia,
Vélez Iván Darío
Publication year - 2017
Publication title -
journal of evidence‐based medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.885
H-Index - 22
ISSN - 1756-5391
DOI - 10.1111/jebm.12245
Subject(s) - medicine , cost effectiveness , adverse effect , surgery , risk analysis (engineering)
Objective The treatment of cutaneous leishmaniasis is toxic, has contraindications, and a high cost. The objective of this study was to estimate the cost‐effectiveness of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis. Methods Effectiveness was the proportion of healing and safety with the adverse effects; these parameters were estimated from a controlled clinical trial and a meta‐analysis. A standard costing was conducted. Average and incremental cost‐effectiveness ratios were estimated. The uncertainty regarding effectiveness, safety, and costs was determined through sensitivity analyses. Results The total costs were $66,807 with Glucantime and $14,079 with thermotherapy. The therapeutic effectiveness rates were 64.2% for thermotherapy and 85.1% for Glucantime. The average cost‐effectiveness ratios ranged between $721 and $1275 for Glucantime and between $187 and $390 for thermotherapy. Based on the meta‐analysis, thermotherapy may be a dominant strategy. Conclusion The excellent cost‐effectiveness ratio of thermotherapy shows the relevance of its inclusion in guidelines for the treatment.