{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:48:09Z","timestamp":1772160489254,"version":"3.50.1"},"reference-count":58,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2007,2,1]],"date-time":"2007-02-01T00:00:00Z","timestamp":1170288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2007,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective\u2002<\/jats:bold>\n                    To facilitate the choice of the best visceral leishmaniasis (VL) treatment strategy for first\u2010line health services in (VL)\u2010endemic areas, we compared in a formal decision analysis the cost and the cost\u2010effectiveness of the different available options.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods\u2002<\/jats:bold>\n                    We selected four drug regimens for VL on the basis of frequency of use, feasibility and reported efficacy studies. The point estimates and the range of plausible values of effectiveness and cost were retrieved from a literature review. A decision tree was constructed and the strategy minimizing the cost per death averted was selected.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results\u2002<\/jats:bold>\n                    Treatment with amphotericin B deoxycholate was the most effective approach in the baseline analysis and averted 87.2% of all deaths attributable to VL. The least expensive and the most cost\u2010effective treatment was the miltefosine regimen, and the most expensive and the least cost\u2010effective was AmBisome\n                    <jats:sup>\u00ae<\/jats:sup>\n                    treatment. The cost of drug and medical care are the main determinants of the cost\u2010effectiveness ranking of the alternative schemes. Sensitivity analysis showed that antimonial was competitive with miltefosine in the low\u2010resistance regions.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion\u2002<\/jats:bold>\n                    In areas with &gt;94% response rates to antimonials, generic sodium stibogluconate remains the most cost\u2010effective option for VL treatment, mainly due to low drug cost. In other regions, miltefosine is the most cost\u2010effective option of treatment, but its use as a first\u2010line drug is limited by its teratogenicity and rapid resistance development. AmBisome in mono\u2010 or combination therapy is too expensive to compete in cost\u2010effectiveness with the other regimens.\n                  <\/jats:p>","DOI":"10.1111\/j.1365-3156.2006.01782.x","type":"journal-article","created":{"date-parts":[[2010,8,11]],"date-time":"2010-08-11T17:54:07Z","timestamp":1281549247000},"page":"274-283","source":"Crossref","is-referenced-by-count":44,"title":["Drug policy for visceral leishmaniasis: a cost\u2010effectiveness analysis"],"prefix":"10.1111","volume":"12","author":[{"given":"V.","family":"Vanlerberghe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Diap","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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