title: Costs of patient management of visceral leishmaniasis in Muzaffarpur, Bihar, India.
abstract: OBJECTIVE
  To identify and quantify the direct and indirect economic cost of treatment for visceral leishmaniasis (VL) with conventional Amphotericin B deoxycholate, currently the first-line treatment in Muzaffarpur.
  
  
  METHODS
  Costs of patient management for VL were estimated from a societal and household perspective by means of a questionnaire designed for this study, interviews and financial reports.
  
  
  RESULTS
  The total cost of care per episode of VL from the societal perspective was estimated at US$355, equivalent to 58% of annual household income. The largest cost category was medical costs (55%), followed by indirect costs (36%) and non-medical costs (9%). The cost from the household perspective was equivalent to US$217. The largest cost category was indirect costs (59%), followed by medical costs (27%) and non-medical costs (15%). Loss of income because of illness and hospitalization and expenses for drugs were the largest cost components.
  
  
  CONCLUSIONS
  The economic costs related to VL are substantial, both to society and the patient. Public health authorities in Bihar should focus on policies that detect VL in the early stage and implement interventions that minimize the burden to households affected by VL.
authors.affiliation: Institute of Development Policy and Management, University of Antwerp, Antwerp, Belgium. f.meheus@kit.nl
authors.forename: Filip
authors.initials: F
authors.lastname: Meheus
authors.forename: Marleen
authors.initials: M
authors.lastname: Boelaert
authors.forename: Rob
authors.initials: R
authors.lastname: Baltussen
authors.forename: Shyam
authors.initials: S
authors.lastname: Sundar
mesh_terms: D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003840:Deoxycholic Acid / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007182:Income; D007194:India / Q000453:epidemiology; D007898:Leishmaniasis, Visceral / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012959:Socioeconomic Factors
chemical_list: D000981:Antiprotozoal Agents; D004338:Drug Combinations; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination