Examinando por Materia "Leishmaniasis cutánea"

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    Ítem
    Análisis de costo-efectividad de la Termoterapia, en comparación con el Glucantime, para el tratamiento de pacientes con Leishmaniasis cutánea en Colombia 2015
    (Universidad EAFIT, 2016) Cardona Arias, Jaiberth Antonio; Tamayo Plata, Mery Patricia
    Introducción: Leishmaniasis cutánea genera una elevada carga de la enfermedad en Colombia y los tratamientos disponibles presentan toxicidad sistémica, baja adherencia, contraindicaciones y alto costo -- Objetivo: Estimar la de costo-efectividad de la termoterapia, en comparación con el Glucantime, en pacientes con leishmaniasis cutánea de Colombia 2015 -- Métodos: Estudio de costo-efectividad desde la perspectiva institucional en 8.113 casos incidentes -- Se incluyeron datos de eficacia y seguridad terapéuticas, se realizó un costeo estándar y los desenlaces fueron los Años de Vida Ajustados por Discapacidad (DALYs) y el número de pacientes curados -- Las fuentes de información fueron el Sistema de Vigilancia en Salud Pública de Colombia, estudios de carga de la enfermedad y un metanálisis desarrollado por el investigador principal de este estudio -- Se estableció la costo-efectividad en términos incrementales y se evaluó la incertidumbre con el gráfico de tornado y simulaciones de Monte Carlo -- Resultados: La aplicación de termoterapia cuesta $1.530.444.433, el manejo de los efectos adversos $89.162.112 y el de las fallas terapéutica $915.460.665, mientras que en Glucantime fueron $8.333.121.916, $177.733.234 y $1.239.616.610, respectivamente -- Con Termoterapia cada DALY evitado cuesta $6.290.510 y cada paciente curado $214.835, en Glucantime $12.936.660 por DALY evitado y $258.231 por paciente curado -- En las simulaciones de Monte Carlo la termoterapia fue dominante para los DALYs evitados en el 67,9% de los casos y fue altamente costo-efectiva para los pacientes curados en un 72% -- Conclusión: En Colombia la termoterapia puede incluirse como una estrategia costo-efectiva para el manejo de la Leishmaniasis cutánea en, su incorporación en las guías de práctica clínica podría representar ahorros de aproximadamente 32 millones de pesos por cada DALY evitado y gastos de $352.830 por cada paciente curado adicional, en comparación con el uso del Glucantime; esto evidencia la relevancia de su incorporación en nuestro país y otros con patrones parasitológicos, clínicos y epidemiológicos similares
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    Ítem
    Comprehensive economic evaluation of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia
    (Universidad EAFIT, 2018-01-15) Cardona-Arias, Jaiberth Antonio; López Carvajal, Liliana; Tamayo Plata, Mery Patricia; jaiberthcardona@gmail.co; lililopez14@gmail.com; mptamayo@eafit.edu.co; c
    Background: Cutaneous leishmaniasis causes a high disease burden in Colombia, and available treatments present systemic toxicity, low patient compliance, contraindications, and high costs. Objective: To estimate the cost-effectiveness of thermotherapy versus Glucantime in patients with cutaneous leishmaniasis in Colombia. Methods: Cost-effectiveness study from an institutional perspective in 8,133 incident cases. Data on therapeutic efficacy and safety were included, calculating standard costs; the outcomes were disability adjusted life years (DALYs) and the number of patients cured. The information sources were the Colombian Public Health Surveillance System, disease burden studies, and one meta-analysis of controlled clinical trials. Incremental cost-effectiveness was determined, and uncertainty was evaluated with tornado diagrams and Monte Carlo simulations. Results: Thermotherapy would generate costs of US$ 501,621; the handling of adverse effects, US$ 29,224; and therapeutic failures, US$ 300,053. For Glucantime, these costs would be US$ 2,731,276, US$ 58,254, and US$ 406,298, respectively. With thermotherapy, the cost would be US$ 2,062 per DALY averted and US$ 69 per patient cured; with Glucantime, the cost would be US$ 4,241 per DALY averted and US$ 85 per patient cured. In Monte Carlo simulations, thermotherapy was the dominant strategy for DALYs averted in 67.9% of cases and highly cost-effective for patients cured in 72%. Conclusion: In Colombia, thermotherapy can be included as a cost-effective strategy for the management of cutaneous leishmaniasis. Its incorporation into clinical practice guidelines could represent savings of approximately US$ 10,488 per DALY averted and costs of US$ 116 per additional patient cured, compared to the use of Glucantime. These findings show the relevance of the incorporation of this treatment in our country and others with similar parasitological, clinical, and epidemiological patterns.
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    Ítem
    Cost-effectiveness analysis of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis
    (Universidad EAFIT, 2018-02-01) Cardona-Arias, Jaiberth Antonio; López Carvajal, Liliana; Tamayo Plata, Mery Patricia; Veléz, Iván Darío; jaiberthcardona@gmail.co; lililopez14@gmail.com; mptamayo@eafit.edu.co; idvelez@pecet-colombia.org
    Introduction: The treatment of cutaneous leishmaniasis is toxic, has contraindications and a high cost. Objective: 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 were 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 $1,275 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.