Subject(s)
Tuberculosis/diagnosis , Antiviral Agents/economics , Cost-Benefit Analysis , Humans , Interferon-gamma/economics , Microbial Sensitivity Tests/economics , Microbial Sensitivity Tests/methods , Microscopy/economics , Microscopy/methods , Nucleic Acid Amplification Techniques/economics , Nucleic Acid Amplification Techniques/methods , Periodicals as Topic , Sensitivity and Specificity , Tuberculin Test/economics , Tuberculin Test/methodsABSTRACT
Visceral leishmaniasis (VL) is a severe disease associated with infection of the reticuloendothelial system by Leishmania species. The infection is acquired through sandfly bites. Recent large scale epidemics of VL in east Africa and India and the emergence of a HIV epidemic make VL a priority for the World Health Organization. Pentavalent antimonials have been cornerstone of treatment for the last six decades. The appearance of antimonial-resistance and the development of lipid formulations of amphotericin B have changed the pattern of VL treatment. Within the past five years, miltefosine has been demonstrated as the first effective and safe oral treatment against VL. The price of miltefosine is yet to be determined. However, miltefosine will certainly be cheaper than lipid formulations of amphotericin B, which are beyond the financial capacity of the poor countries. Because it can be administered orally, miltefosine is suited for the treatment of large number of patients who get affected during epidemics, particularly in regions where the parasites are resistant to the currently used agents. Here, we recommend different treatment schedules according to the resistance pattern and the region-specific socio-economical and cultural factors.
Subject(s)
Antiprotozoal Agents/therapeutic use , Leishmania/drug effects , Leishmaniasis, Visceral/drug therapy , AIDS-Related Opportunistic Infections/complications , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/parasitology , Animals , Antiprotozoal Agents/economics , Antiviral Agents/economics , Antiviral Agents/therapeutic use , Drug Resistance , HIV Infections/complications , Humans , Interferon-gamma/economics , Interferon-gamma/therapeutic use , Leishmaniasis, Visceral/complications , Leishmaniasis, Visceral/epidemiologySubject(s)
Drug Approval/legislation & jurisprudence , Drug Industry/economics , Interferon-gamma/therapeutic use , Pulmonary Fibrosis/drug therapy , Biotechnology , Clinical Trials, Phase III as Topic , Drug Costs , Drug Industry/legislation & jurisprudence , Humans , Interferon-gamma/economics , Investments , Recombinant Proteins , United States , United States Food and Drug AdministrationABSTRACT
A number of novel biologic agents are being introduced to replace, enhance, or modulate immune responses in medical illnesses. The use of these therapies has become crucial in treating some of these diseases, yet there is relatively little available information about their cost-effectiveness. Two examples are presented. Interferon gamma, used in chronic granulomatous disease, costs about $140 for a 100-microg vial; yearly costs average $21840 per patient. Study data estimated a 69% to 76% reduction in serious illness with interferon gamma treatment; a reduced incidence of infections could cover drug costs. Intravenous immunoglobulin is used lifelong in antibody deficiency and clearly reduces the number of serious illnesses. Projected savings derive from fewer hospital admissions and reduced organ damage, but infusion costs vary widely because of the prices charged for the drug and infusion services.
