The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission.
BACKGROUND:The World Health Organization's 2020 Goals for Chagas disease include access to antiparasitic treatment and care of all infected/ill patients. Policy makers need to know the economic value of identifying and treating patients earlier. However, the economic value of earlier treatment...
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ftdoajarticles:oai:doaj.org/article:a3a070800ecd4aa28bdadeb26ef2e214 2023-05-15T15:16:33+02:00 The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission. Sarah M Bartsch Cameron M Avelis Lindsey Asti Daniel L Hertenstein Martial Ndeffo-Mbah Alison Galvani Bruce Y Lee 2018-11-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006809 https://doaj.org/article/a3a070800ecd4aa28bdadeb26ef2e214 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC6237415?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006809 https://doaj.org/article/a3a070800ecd4aa28bdadeb26ef2e214 PLoS Neglected Tropical Diseases, Vol 12, Iss 11, p e0006809 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006809 2022-12-31T03:41:46Z BACKGROUND:The World Health Organization's 2020 Goals for Chagas disease include access to antiparasitic treatment and care of all infected/ill patients. Policy makers need to know the economic value of identifying and treating patients earlier. However, the economic value of earlier treatment to cure and prevent the Chagas' spread remains unknown. METHODS:We expanded our existing Chagas disease transmission model to include identification and treatment of Chagas disease patients. We linked this to a clinical and economic model that translated chronic Chagas disease cases into health and economic outcomes. We evaluated the impact and economic outcomes (costs, cost-effectiveness, cost-benefit) of identifying and treating different percentages of patients in the acute and indeterminate disease states in a 2,000-person village in Yucatan, Mexico. RESULTS:In the absence of early treatment, 50 acute and 22 new chronic cases occurred over 50 years. Identifying and treating patients in the acute stage averted 0.5-5.4 acute cases, 0.6-5.5 chronic cases, and 0.6-10.8 disability-adjusted life years (DALYs), saving $694-$7,419 and $6,976-$79,950 from the third-party payer and societal perspectives, respectively. Treating in the indeterminate stage averted 2.2-4.9 acute cases, 6.1-12.8 chronic cases, and 11.7-31.1 DALYs, saving $7,666-$21,938 from the third-party payer perspective and $90,530-$243,068 from the societal perspective. Treating patients in both stages averted ≤9 acute cases and ≤15 chronic cases. Identifying and treating patients early was always economically dominant compared to no treatment. Identifying and treating patients earlier resulted in a cumulative cost-benefit of $7,273-$224,981 at the current cost of identification and treatment. CONCLUSIONS:Even when identifying and treating as little as 5% of cases annually, treating Chagas cases in the acute and indeterminate stages reduces transmission and provides economic and health benefits. This supports the need for improved diagnostics and access to safe ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 11 e0006809 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Sarah M Bartsch Cameron M Avelis Lindsey Asti Daniel L Hertenstein Martial Ndeffo-Mbah Alison Galvani Bruce Y Lee The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:The World Health Organization's 2020 Goals for Chagas disease include access to antiparasitic treatment and care of all infected/ill patients. Policy makers need to know the economic value of identifying and treating patients earlier. However, the economic value of earlier treatment to cure and prevent the Chagas' spread remains unknown. METHODS:We expanded our existing Chagas disease transmission model to include identification and treatment of Chagas disease patients. We linked this to a clinical and economic model that translated chronic Chagas disease cases into health and economic outcomes. We evaluated the impact and economic outcomes (costs, cost-effectiveness, cost-benefit) of identifying and treating different percentages of patients in the acute and indeterminate disease states in a 2,000-person village in Yucatan, Mexico. RESULTS:In the absence of early treatment, 50 acute and 22 new chronic cases occurred over 50 years. Identifying and treating patients in the acute stage averted 0.5-5.4 acute cases, 0.6-5.5 chronic cases, and 0.6-10.8 disability-adjusted life years (DALYs), saving $694-$7,419 and $6,976-$79,950 from the third-party payer and societal perspectives, respectively. Treating in the indeterminate stage averted 2.2-4.9 acute cases, 6.1-12.8 chronic cases, and 11.7-31.1 DALYs, saving $7,666-$21,938 from the third-party payer perspective and $90,530-$243,068 from the societal perspective. Treating patients in both stages averted ≤9 acute cases and ≤15 chronic cases. Identifying and treating patients early was always economically dominant compared to no treatment. Identifying and treating patients earlier resulted in a cumulative cost-benefit of $7,273-$224,981 at the current cost of identification and treatment. CONCLUSIONS:Even when identifying and treating as little as 5% of cases annually, treating Chagas cases in the acute and indeterminate stages reduces transmission and provides economic and health benefits. This supports the need for improved diagnostics and access to safe ... |
format |
Article in Journal/Newspaper |
author |
Sarah M Bartsch Cameron M Avelis Lindsey Asti Daniel L Hertenstein Martial Ndeffo-Mbah Alison Galvani Bruce Y Lee |
author_facet |
Sarah M Bartsch Cameron M Avelis Lindsey Asti Daniel L Hertenstein Martial Ndeffo-Mbah Alison Galvani Bruce Y Lee |
author_sort |
Sarah M Bartsch |
title |
The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission. |
title_short |
The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission. |
title_full |
The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission. |
title_fullStr |
The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission. |
title_full_unstemmed |
The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission. |
title_sort |
economic value of identifying and treating chagas disease patients earlier and the impact on trypanosoma cruzi transmission. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006809 https://doaj.org/article/a3a070800ecd4aa28bdadeb26ef2e214 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 11, p e0006809 (2018) |
op_relation |
http://europepmc.org/articles/PMC6237415?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006809 https://doaj.org/article/a3a070800ecd4aa28bdadeb26ef2e214 |
op_doi |
https://doi.org/10.1371/journal.pntd.0006809 |
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PLOS Neglected Tropical Diseases |
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12 |
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11 |
container_start_page |
e0006809 |
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1766346840091918336 |