ArticleIJID regions2025
Prevention of rheumatic heart disease in New Zealand: High-dose subcutaneous benzathine penicillin is cost-saving compared with traditional intramuscular injections.
Article in IJID regions, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Objectives: Acute rheumatic fever is a preventable condition that can lead to chronic illness and early death. Standard prevention with 4-weekly intramuscular (IM) benzathine penicillin G (BPG) injections for ≥10 years may be associated with poor adherence. High-dose 10-weekly subcutaneous penicillin injections (SCIP) may improve adherence by reducing injection frequency. Since 2025, SCIP has been included in the repository of standard operating procedures in lower North Island hospitals in New Zealand (NZ). We compare the costs of delivering a full course of secondary prophylaxis using SCIP vs IM BPG injections in NZ children with a first acute rheumatic fever presentation and no/mild carditis. Methods: Treatment administration costs and productivity losses from SCIP vs IM BPG were modeled using real-world survey data on time off school and work. Starting age of secondary prophylaxis, adherence, and administration site over the treatment period were varied. Costs are in 2024 NZ$, discounted at 3.5%. Results: SCIP reduced 12-month costs by nearly half to NZ$ 1629 for a 10-year-old child. Over a full course, SCIP consistently offered societal cost-savings, especially in younger children and higher adherence scenarios. Conclusions: Prevention using SCIP is cost-saving to NZ society. Increased adherence to SCIP may contribute to longer, healthier lives for those diagnosed with rheumatic fever.
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