Anthropometrically derived dosing and drug costing calculations for treating visceral leishmaniasis in Bihar, India.
OBJECTIVE
To estimate drug costs of treating visceral leishmaniasis (VL) based on data on the VL population structure from the high-burden, antimony-resistant area of Northern Bihar, India.


RESULTS
Paromomycin is the cheapest option ($7450 to treat 1000 patients). Treating 1000 patients with oral miltefosine would cost $119,250 at the current private market price or $64,383-$75,129 at preferential public sector price depending on the size of the order. With AmBisome it would be $163,600 or $229,500 depending on the dose (10 or 15 mg/kg total). These costs are without considering other direct costs (daily intramuscular injections for 3 weeks for paromomycin; intravenous devices and hospitalization for AmBisome; directly observed treatment if applied for miltefosine) and indirect costs.


CONCLUSIONS
These calculations provide useful basic information for projections.
Olliaro
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P
UNICEF/UNDP/WB/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland. olliarop@who.int
Sundar
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S
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000886:Anthropometry / Q000379:methods; D000981:Antiprotozoal Agents / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000188:drug therapy* / Q000191:economics; D008081:Liposomes; D008297:Male; D008875:Middle Aged; D010303:Paromomycin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D010767:Phosphorylcholine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D017678:Sex Distribution
D000981:Antiprotozoal Agents; D008081:Liposomes; C068538:liposomal amphotericin B; D010767:Phosphorylcholine; C039128:miltefosine; D010303:Paromomycin; D000666:Amphotericin B