Treatment of antimony-unresponsive Indian visceral leishmaniasis with ultra-short courses of amphotericin-B-lipid complex

Sundar, Shyam; Goyal, Ashish; More, Deepak K.; Singh, Manoj Kumar; Murray, Henry W.

doi:10.1080/00034983.1998.11813337

Cited by 29 publications

(25 citation statements)

References 23 publications

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“…However, the data presented are not comparable to the estimates found herein because of the methodological differences and specificities for each study, including the evaluation of different therapeutic regimens and variations in drug costs. Sundar et al 24 reported that the direct costs of treatment ranged from USD 490.00-845.00 when patients were treated with different drug regimens containing liposomal amphotericin B in Bihar, India. Additionally, the same location, the estimated direct cost of treatment with amphotericin B deoxycholate was USD 260.00 25 .…”

Section: Discussionmentioning

confidence: 99%

The direct costs of treating human visceral leishmaniasis in Brazil

Assis

Rosa

Teixeira

et al. 2017

Rev. Soc. Bras. Med. Trop.

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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 per kg per day for 30 days; 2) N-methyl glucamine antimoniate intravenously at 20mg per kg per day for 30 days; 3) amphotericin B deoxycholate at 1mg per kg per day for 21 days; and 4) liposomal amphotericin B at 3mg per kg per day for a 7 days treatment. Results: The estimated direct costs of treatment for an adult patient using N-methylglucamine antimoniate administered via the intramuscular and intravenous routes were USD 418.52 and USD 669.40, respectively. The estimated cost of treatment with amphotericin B deoxycholate was USD 1,522.70. Finally, the estimated costs of treatment with liposomal amphotericin B were USD 659.79, and USD 11,559.15 using the price adopted by the WHO and the Drug Regulation Board, respectively. Conclusions: This analysis indicates the economic feasibility of replacing N-methyl glucamine antimoniate with liposomal amphotericin B, which allows a shorter treatment period with less toxicity compared with other treatments, provided that the purchase value used by the WHO and transferred to the MH is maintained.

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Section: Discussionmentioning

confidence: 99%

The direct costs of treating human visceral leishmaniasis in Brazil

Assis

Rosa

Teixeira

et al. 2017

Rev. Soc. Bras. Med. Trop.

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“…20,22,23,48,49,50 Efficacy was doserelated in dose-finding studies. Short-course (2 day) regimens were only approximately 80% effective.…”

Section: Reviewmentioning

confidence: 99%

Treatment options for visceral leishmaniasis: a systematic review of clinical studies done in India, 1980–2004

Olliaro

Guérin

Gerstl

et al. 2005

The Lancet Infectious Diseases

204

181

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“…Sundar et al (1997Sundar et al ( , 1998aSundar et al ( , 2001Sundar et al ( , 2002bSundar et al ( , 2004, Murray (2000), Syriopoulou et al (2003) Values used in baseline analysis are given in bold. Range of plausible values between parentheses.…”

Section: Decision Tree Structurementioning

confidence: 99%

Drug policy for visceral leishmaniasis: a cost‐effectiveness analysis

Vanlerberghe

Diap

Guérin³

et al. 2007

Tropical Med Int Health

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Summaryobjective To facilitate the choice of the best visceral leishmaniasis (VL) treatment strategy for first-line health services in (VL)-endemic areas, we compared in a formal decision analysis the cost and the costeffectiveness of the different available options.methods We selected four drug regimens for VL on the basis of frequency of use, feasibility and reported efficacy studies. The point estimates and the range of plausible values of effectiveness and cost were retrieved from a literature review. A decision tree was constructed and the strategy minimizing the cost per death averted was selected.results Treatment with amphotericin B deoxycholate was the most effective approach in the baseline analysis and averted 87.2% of all deaths attributable to VL. The least expensive and the most costeffective treatment was the miltefosine regimen, and the most expensive and the least cost-effective was AmBisome Ò treatment. The cost of drug and medical care are the main determinants of the costeffectiveness ranking of the alternative schemes. Sensitivity analysis showed that antimonial was competitive with miltefosine in the low-resistance regions.conclusion In areas with >94% response rates to antimonials, generic sodium stibogluconate remains the most cost-effective option for VL treatment, mainly due to low drug cost. In other regions, miltefosine is the most cost-effective option of treatment, but its use as a first-line drug is limited by its teratogenicity and rapid resistance development. AmBisome in mono-or combination therapy is too expensive to compete in cost-effectiveness with the other regimens.keywords visceral leishmaniasis, drug policy, cost-effectiveness analysis

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Treatment of antimony-unresponsive Indian visceral leishmaniasis with ultra-short courses of amphotericin-B-lipid complex

Cited by 29 publications

References 23 publications

The direct costs of treating human visceral leishmaniasis in Brazil

The direct costs of treating human visceral leishmaniasis in Brazil

Treatment options for visceral leishmaniasis: a systematic review of clinical studies done in India, 1980–2004

Drug policy for visceral leishmaniasis: a cost‐effectiveness analysis

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