Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil

Abstract

Cutaneous leishmaniasis (CL) is a disease associated with low-income populations. Thus, in assessing the burden of this disease, it is important to include its economic impact on individuals. We aimed to evaluate CL economic impact on patients treated at a referral service in the State of Minas Gerais, Brazil. This is a cross-sectional study based on the analysis of interviews and medical records from which we assembled direct medical and non-medical costs related to CL, from a societal perspective. One hundred patients were included; 50% had a monthly per capita income of up to USD 259.60 and spent on average USD 187.32 with the disease, representing an average monthly impact of 22.5% (USD 133.80). The disease imposed direct medical costs, such as: private medical appointments, medications, medical exams, dressing material, and co-participation in health insurances. Direct non-medical costs were mainly related to patients’ transportation to health centers (USD 4,911.00), but also included medically-necessary care, food, and domestic and business outsourcing services. Although the Brazilian public health system guarantees access to health care, CL still represents a substantial economic impact for patients. The main action to reduce the expenses with this disease is decentralizing services for CL diagnosis and therapeutic approach, as well as increasing their efficiency.

Vulnerabilities to and the Socioeconomic and Psychosocial Impacts of the Leishmaniases: A Review

“… 147 In Brazil, 50% of study participants paid an average of 22% of their household income for CL-related costs. 148 In Bangladesh, the median total household cost per patient for PKDL treatment was $367, which was more than twice the per capita annual income of the studied population. 19 …”

“…A 2017 cross-sectional study in Brazil found the total medical costs to CL patients was $125. 148 Top contributors to direct medical costs included medications (17%), medical appointments (15%), medical exams (9%) and health insurance costs (10%). Top contributors to direct non-medical costs were transportation to health centers (26%) and food (8%).…”

“…Top contributors to direct non-medical costs were transportation to health centers (26%) and food (8%). 148 …”

“…Research and Reports in Tropical Medicine 2021:12 medical costs were transportation to health centers (26%) and food (8%). 148 Only one study of the economic impact of PKDL was found. 19 In Bangladesh, the mean total direct cost per treated patient was $179.…”

Economic evaluations addressing diagnosis and treatment strategies for neglected tropical diseases: an overview

“…Galvão et al 18 evaluated direct medical and non-medical costs related to CL treatment in a Brazilian referral center. One hundred patients were included; 50% had a monthly per capita income of up to USD 259.60 and spent on average USD 187.32 with the disease, representing an average monthly impact of 22.5% (USD 133.80).…”