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Cost‐effectiveness of liposomal amphotericin B in hospitalised patients with mucocutaneous leishmaniasis
Author(s) -
Mistro Sóstenes,
Gomes Bárbara,
Rosa Lorena,
Miranda Ligia,
Camargo Marianne,
Badaró Roberto
Publication year - 2017
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12996
Subject(s) - medicine , mucocutaneous zone , leishmaniasis , amphotericin b , cost effectiveness , surgery , dermatology , antifungal , immunology , disease , risk analysis (engineering)
Objective To compare the cost‐effectiveness of L‐AmB with that of Sb V 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 Sb V 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 Sb V group. Markov chain analyses showed that the group that started therapy with Sb V 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 Sb V 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 Sb V and AmB‐D owing to its higher effectiveness, safety and shorter course.