ArticlePLoS neglected tropical diseases2019
"Cheaper and better": Societal cost savings and budget impact of changing from systemic to intralesional pentavalent antimonials as the first-line treatment for cutaneous leishmaniasis in Bolivia.
Article in PLoS neglected tropical diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Integrated diagnosis and successful treatment of imported old world cutaneous leishmaniasis with intralesional sodium stibogluconate in china: a case report.Parasitology research · 2025Article
- Cutaneous leishmaniasis: epidemiology, treatment access and translational challenges of topical therapies.Frontiers in microbiology · 2025Review
- Data-driven predictions of potential Leishmania vectors in the Americas.PLoS neglected tropical diseases · 2023Article
- "It's not all about the disease": do treatment and socioeconomic status affect perceived impact and satisfaction of patients treated for cutaneous leishmaniasis?Revista da Sociedade Brasileira de Medicina Tropical · 2023Article
- [Synthesis of evidence and recommendations: guideline for the treatment of leishmaniasis in the Region of the AmericasSíntese de evidências e recomendações: diretrizes para o tratamento das leishmanioses na Região das Américas].Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- Intralesional Meglumine Antimoniate: Safe, Feasible and Effective Therapy for Cutaneous Leishmaniasis in Bolivia.Tropical medicine and infectious disease · 2022Article
- Estimating the global demand curve for a leishmaniasis vaccine: A generalisable approach based on global burden of disease estimates.PLoS neglected tropical diseases · 2022Article
- Efficacy of topical Miltefosine formulations in an experimental model of cutaneous leishmaniasis.Drug delivery and translational research · 2022Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCutaneous leishmaniasis (CL), endemic in Bolivia, mostly affects poor people in rainforest areas. The current first-line treatment consists of systemic pentavalent antimonials (SPA) for 20 days and is paid for by the Ministry of Health (MoH). Long periods of drug shortages and a lack of safe conditions to deliver treatment are challenges to implementation. Intralesional pentavalent antimonials (ILPA) are an alternative to SPA. This study aims to compare the cost of ILPA and SPA, and to estimate the health and economic impacts of changing the first-line treatment for CL in a Bolivian endemic area.
methodsThe cost-per-patient treated was estimated for SPA and ILPA from the perspectives of the MoH and society. The quantity and unit costs of medications, staff time, transportation and loss of production were obtained through a health facility survey (N = 12), official documents and key informants. A one-way sensitivity analysis was conducted on key parameters to evaluate the robustness of the results. The annual number of patients treated and the budget impact of switching to ILPA as the first-line treatment were estimated under different scenarios of increasing treatment utilization. Costs were reported in 2017 international dollars (1 INT$ = 3.10 BOB).
resultsTreating CL using ILPA was associated with a cost-saving of $248 per-patient-treated from the MoH perspective, and $688 per-patient-treated from the societal perspective. Switching first-line treatment to ILPA while maintaining the current budget would allow two-and-a-half times the current number of patients to be treated. ILPA remained cost-saving compared to SPA in the sensitivity analysis.
conclusionsThe results of this study support a shift to ILPA as the first-line treatment for CL in Bolivia and possibly in other South American countries.
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