Economic and Financial Evaluation of Neglected Tropical Diseases

Lee, Bruce Y.; Bartsch, Sarah M.; Gorham, Katrin M.

doi:10.1016/bs.apar.2015.01.002

Cited by 24 publications

(15 citation statements)

References 98 publications

(117 reference statements)

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“…Other diseases occurring in the same geographic area cause anemia and cognitive impairment (e.g., malaria, schistosomiasis, and meningitis), which may make it difficult to attribute the true underlying cause and infected individuals may not seek care or be appropriately diagnosed. [ 40 ] Data used in our model came from a variety of sources and studies of variable quality; therefore our results may change as more data becomes available. For example, hookworm prevalence data is limited; it tends to be extrapolated from localized cross-sectional surveys, many of which are done in high prevalence areas with differing data collection methods.…”

Section: Discussionmentioning

confidence: 99%

The Global Economic and Health Burden of Human Hookworm Infection

et al. 2016

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BackgroundEven though human hookworm infection is highly endemic in many countries throughout the world, its global economic and health impact is not well known. Without a better understanding of hookworm’s economic burden worldwide, it is difficult for decision makers such as funders, policy makers, disease control officials, and intervention manufacturers to determine how much time, energy, and resources to invest in hookworm control.Methodology/Principle FindingsWe developed a computational simulation model to estimate the economic and health burden of hookworm infection in every country, WHO region, and globally, in 2016 from the societal perspective. Globally, hookworm infection resulted in a total 2,126,280 DALYs using 2004 disability weight estimates and 4,087,803 DALYs using 2010 disability weight estimates (excluding cognitive impairment outcomes). Including cognitive impairment did not significantly increase DALYs worldwide. Total productivity losses varied with the probability of anemia and calculation method used, ranging from $7.5 billion to $138.9 billion annually using gross national income per capita as a proxy for annual wages and ranging from $2.5 billion to $43.9 billion using minimum wage as a proxy for annual wages.ConclusionEven though hookworm is classified as a neglected tropical disease, its economic and health burden exceeded published estimates for a number of diseases that have received comparatively more attention than hookworm such as rotavirus. Additionally, certain large countries that are transitioning to higher income countries such as Brazil and China, still face considerable hookworm burden.

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Section: Discussionmentioning

confidence: 99%

The Global Economic and Health Burden of Human Hookworm Infection

et al. 2016

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“…Ivermectin is currently donated for onchocerciasis and lymphatic filariasis control ( 25 Years: The MECTIZANⓇ Donation Program ), but not directly for STH. Consequently, the actual financial cost of ivermectin and/or its potential economic value if it were to be donated for STH needs to be estimated to allow future cost-effectiveness analysis (an important gap for NTDs ( Turner et al, 2014b , Turner et al, 2015a , Lee et al, 2015 )).…”

Section: Discussionmentioning

confidence: 99%

Analysis of the population-level impact of co-administering ivermectin with albendazole or mebendazole for the control and elimination of Trichuris trichiura

Turner

Truscott

Bettis

et al. 2016

Parasite Epidemiology and Control

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IntroductionSoil-transmitted helminth (STH) infections are predominately controlled by providing children with preventive chemotherapy with either albendazole or mebendazole. However, neither has a high efficacy against Trichuris trichiura. This low efficacy limits the overall effectiveness of the current STH control programmes against T. trichiura. It has been demonstrated that co-administering ivermectin with albendazole or mebendazole significantly increases the efficacy of current treatments, which may increase the overall effectiveness of control programmes.MethodsUsing a STH transmission mathematical model, we evaluated the potential impact of co-administering ivermectin with albendazole or mebendazole to treat T. trichiura within a preventive chemotherapy programme targeting children (2–15 year olds). We evaluated the impact in terms of reduction in prevalent infections, mean worm burden, and prevalence of heavy infections.ResultsAlthough the current treatment strategy reduced T. trichiura worm burden and prevalence of heavy infections, due to their poor efficacy the long term impact of preventive chemotherapy for children was smaller compared to the other STH. Co-administering ivermectin increased the projected impact of the preventive chemotherapy programme in terms of all three of the explored metrics, practically in high transmission settings. Furthermore, ivermectin co-administration greatly increased the feasibility of and timeframe for breaking transmission.ConclusionsCo-administering ivermectin notably increased the projected impact of preventive chemotherapy in high transmission settings and increased the feasibility for breaking transmission. This has important implications for control programmes, some of which may be shifting focus from morbidity control to interruption of transmission, and some of which may be logistically unable to provide preventive chemotherapy twice a year as recommended. However, the benefit of co-administering ivermectin is limited by the fact that 2–5 year olds are often ineligible to receive treatment.

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“…There is also evidence to suggest that these benefits of MDA can subsequently reduce morbidity[44]. Additionally, some studies have shown increases in school attendance with anthelminthic treatment[45, 46] and MDA had been found to be a cost-effective intervention for STH infections[14, 47]. …”

Section: Discussionmentioning

confidence: 99%

Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting

Bartsch

Hotez

Hertenstein

et al. 2016

Vaccine

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Background Although mass drug administration (MDA) has helped reduce morbidity attributed to soil-transmitted helminth infections in children, its limitations for hookworm infection have motivated the development of a human hookworm vaccine to both improve morbidity control and ultimately help block hookworm transmission leading to elimination. However, the potential economic and epidemiologic impact of a preventive vaccine has not been fully evaluated. Methods We developed a dynamic compartment model coupled to a clinical and economics outcomes model representing both the human and hookworm populations in a high transmission region of Brazil. Experiments simulated different implementation scenarios of MDA and vaccination under varying circumstances. Results Considering only intervention costs, both annual MDA and vaccination were highly cost-effective (ICERs ≤$790/DALY averted) compared to no intervention, with vaccination resulting in lower incremental cost-effectiveness ratios (ICERs ≤$444/DALY averted). From the societal perspective, vaccination was economically dominant (i.e., less costly and more effective) than annual MDA in all tested scenarios, except when vaccination was less efficacious (20% efficacy, 5 year duration) and MDA coverage was 75%. Increasing the vaccine's duration of protection and efficacy, and including a booster injection in adulthood all increased the benefits of vaccination (i.e., resulted in lower hookworm prevalence, averted more disability-adjusted life years, and saved more costs). Assuming its target product profile, a pediatric hookworm vaccine drastically decreased hookworm prevalence in children to 14.6% after 20 years, compared to 57.2% with no intervention and 54.1% with MDA. The addition of a booster in adulthood further reduced the overall prevalence from 68.0% to 36.0%, nearly eliminated hookworm infection in children. Conclusion Using a human hookworm vaccine would be cost-effective and in many cases economically dominant, providing both health benefits and cost-savings. It could become a key technology in effecting control and elimination efforts for hookworm globally.

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Economic and Financial Evaluation of Neglected Tropical Diseases

Cited by 24 publications

References 98 publications

The Global Economic and Health Burden of Human Hookworm Infection

The Global Economic and Health Burden of Human Hookworm Infection

Analysis of the population-level impact of co-administering ivermectin with albendazole or mebendazole for the control and elimination of Trichuris trichiura

Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting

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