Comprehensive economic evaluation of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia

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dc.contributor.authorCardona-Arias, Jaiberth Antonio
dc.contributor.authorLópez Carvajal, Liliana
dc.contributor.authorTamayo Plata, Mery Patricia
dc.contributor.eafitauthorjaiberthcardona@gmail.co
dc.contributor.eafitauthorlililopez14@gmail.com
dc.contributor.eafitauthormptamayo@eafit.edu.co
dc.contributor.eafitauthorc
dc.coverage.spatialMedellín de: Lat: 06 15 00 N degrees minutes Lat: 6.2500 decimal degrees Long: 075 36 00 W degrees minutes Long: -75.6000 decimal degreeseng
dc.date.accessioned2018-06-25T23:01:10Z
dc.date.available2018-06-25T23:01:10Z
dc.date.issued2018-01-15
dc.description.abstractBackground: 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.eng
dc.identifier.urihttp://hdl.handle.net/10784/12418
dc.language.isoengeng
dc.publisherUniversidad EAFITspa
dc.publisher.departmentEscuela de Economía y Finanzasspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccesseng
dc.rights.localAcceso abiertospa
dc.subject.keywordCost-effectiveness evaluationeng
dc.subject.keywordAnálisis costo-efectivospa
dc.subject.keywordCutaneous leishmaniasiseng
dc.subject.keywordLeishmaniasis cutáneaspa
dc.subject.keywordThermotherapyeng
dc.subject.keywordTermoterapiaspa
dc.subject.keywordSodium antimony gluconateeng
dc.subject.keywordGluconato de antimonio sódicospa
dc.subject.keywordColombiaeng
dc.subject.keywordColombiaspa
dc.titleComprehensive economic evaluation of thermotherapy for the treatment of cutaneous leishmaniasis in Colombiaeng
dc.typeworkingPapereng
dc.typeinfo:eu-repo/semantics/workingPapereng
dc.type.hasVersiondrafteng
dc.type.localDocumento de trabajo de investigaciónspa

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