title: Opportunity cost for early treatment of Chagas disease in Mexico.
abstract: BACKGROUND
  Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations.
  
  
  RESULTS
  A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment.
  
  
  CONCLUSIONS
  In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.
authors.affiliation: Regional Center for Public Health Research, National Institute for Public Health Research, Tapachula, Chiapas, Mexico.
authors.forename: Janine M
authors.initials: JM
authors.lastname: Ramsey
authors.affiliation: Center for Research in Health Systems, National Institute for Public Health Research, Cuernavaca, Mexico.
authors.forename: Miguel
authors.initials: M
authors.lastname: Elizondo-Cano
authors.affiliation: Center for Research in Health Systems, National Institute for Public Health Research, Cuernavaca, Mexico.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Sanchez-González
authors.affiliation: Salud, Población y Economía AC, Mexico City, Mexico.
authors.forename: Adriana
authors.initials: A
authors.lastname: Peña-Nieves
authors.affiliation: Epidemiological Research Unit and Health Services, National Medical Center XXI Century, Mexican Social Security Institute, Mexico City, Mexico.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Figueroa-Lara
mesh_terms: D000981:Antiprotozoal Agents / Q000191:economics* / Q000627:therapeutic use*; D014355:Chagas Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000191:economics; D015331:Cohort Studies; D042241:Early Diagnosis; D017048:Health Care Costs; D006801:Humans; D008800:Mexico; D055502:Secondary Prevention / Q000191:economics* / Q000379:methods*
chemical_list: D000981:Antiprotozoal Agents
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