2017
DOI: 10.1590/0037-8682-0133-2017
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Abstract: Introduction:The drugs available for visceral leishmaniasis (VL) treatment in Brazil have specific characteristics in terms of operability, effectiveness, toxicity, and cost. The aim of this study was to estimate the direct costs of therapies recommended by the Ministry of Health (MH) for VL treatment in Brazil. Methods: The analytical perspective used was that adopted by the Brazilian Public Health System. Three drugs and four regimens were included: 1) N-methyl glucamine antimoniate intramuscularly at 20mg p… Show more

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Cited by 16 publications
(11 citation statements)
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“…Additionally, parenteral formulations must be administered in a hospital setting under the supervision of health care professionals. Beyond the direct costs of in-patient treatment, including admission, medical supplies, and charges for physician and laboratory services, there are numerous indirect costs which make this form of treatment impossible for many low-income populations [17,40]. Indirect costs may include: Travel to the healthcare facility, food for the patient and caregiver while in hospital, loss of income of the patient and/or their family members which accompany them, as well as any other unforeseen miscellaneous costs [17].…”
Section: Treating Visceral Leishmaniasis (Vl)mentioning
confidence: 99%
“…Additionally, parenteral formulations must be administered in a hospital setting under the supervision of health care professionals. Beyond the direct costs of in-patient treatment, including admission, medical supplies, and charges for physician and laboratory services, there are numerous indirect costs which make this form of treatment impossible for many low-income populations [17,40]. Indirect costs may include: Travel to the healthcare facility, food for the patient and caregiver while in hospital, loss of income of the patient and/or their family members which accompany them, as well as any other unforeseen miscellaneous costs [17].…”
Section: Treating Visceral Leishmaniasis (Vl)mentioning
confidence: 99%
“…1 In Brazil, for a 60-kg adult patient, the estimated direct costs of treatment of VL with L-AmB at a cumulative dose of 21 mg/kg, including costs of drugs, remuneration of health professionals, consumables, personal protective equipment, and complementary tests, were USD 659.79 and USD 11,559.15 using the WHOnegotiated price and the price adopted by The Drug Regulation Board from National Health Surveillance Agency/Ministry of Health from Brazil, respectively. 33 As part of combination therapy, we decided to use a lower dose of MA (10 mg/kg per day) than the standard one (20 mg/ kg per day) recommended for monotherapy by guidelines and the package insert, based on previous successful reports of rescue therapy with antimony low dose in immunocompromised patients with VL caused by L. infantum. In the study by Morizot et al, 34 three immunocompromised patients (two HIV-infected patients with severe immunosuppression and a kidney transplant recipient with graft rejection), with VL unresponsive to L-AmB, either for therapeutic failure or for relapse, were given a 28-day course of antimony low dose (10 mg Sb 5+ /kg per day for the HIV-infected patients and 170 mg Sb 5+ per day, adjusted for renal clearance, for the kidney transplant recipient), resulting in rapid and sustained clinical and parasitological cure.…”
Section: Discussionmentioning
confidence: 99%
“…These are important in the treatment of neglected tropical diseases (NTDs), such as ML because they mainly affect the poor and vulnerable populations in developing countries 11,12 . Despite this, there are limited economic studies addressing NTDs or, specifically, leishmaniasis 7,[13][14][15][16][17] . Even if SUS adopts miltefosine in Brazil for TL, we currently lack the evidence demonstrating its efficacy, specifically for treating ML.…”
Section: Introductionmentioning
confidence: 99%