菲律宾三宝颜半岛在控制土壤传播蠕虫方面,大规模用药与扩大校本定向预防性化疗的成本和预算影响比较

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet Regional Health: Western Pacific Pub Date : 2024-08-07 DOI:10.1016/j.lanwpc.2024.101162
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引用次数: 0

摘要

背景以学校为基础的定向预防性化疗(PC)是控制土壤传播蠕虫(STH)的主要策略,通常以小学生为重点,2016 年菲律宾将其扩展到中学生。该计划仍将成人排除在外,而成人也可能会有相当高的发病率,并可能成为重要的感染源。大规模用药(MDA)是指对所有人群进行治疗,这将带来更多的健康益处,但也会增加实施成本。方法 2021 年在三宝颜半岛地区进行了一项成本调查,从政府支付方的角度估算了实施大规模给药与扩大学校定向 PC 相比的经济和财务成本。进行了预算影响分析,以估算政府在五年时间内实施 MDA 的财务成本。蒙特卡洛模拟法考虑了成本估算的不确定性。研究结果:MDA 的经济成本为每年 80.9 万美元(95% CI:67.9 万美元-95 万美元),即每个目标人群 0.22 美元(95% CI:0.19 美元-0.26 美元),而扩大的校内目标 PC 的成本为 62.5 万美元(95% CI:54.9 万美元-70.6 万美元),即每个目标人群 0.57 美元(95% CI:0.50 美元-0.64 美元)。在五年内,政府为实施 MDA 所承担的财务成本为 3,113,000 美元(95% CI:2,475,000-3,810,000 美元);比扩大的校本目标 PC 高出 740,000 美元(95% CI:486,000-1,019,000 美元)。该项目由澳大利亚控制和消除被忽视热带病中心(NHMRC GA19028)资助,JPCDT 得到了新南威尔士大学科学博士奖学金的支持。SVN由NHMRC调查员资助金(APP 2018220)资助。
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Cost and budget impact of mass drug administration compared to expanded school-based targeted preventive chemotherapy for soil-transmitted helminth control in Zamboanga Peninsula, the Philippines

Background

School-based targeted preventive chemotherapy (PC), the primary strategy for soil-transmitted helminth (STH) control, typically focusing on primary schoolchildren, was expanded to secondary school students in the Philippines in 2016. This program still excludes adults, who may also suffer from considerable morbidity and can be a significant reservoir of infection. Mass drug administration (MDA), where the entire population is treated, would bring additional health benefits but will also increase implementation costs. The incremental cost of implementing MDA for STH control compared to expanded school-based targeted PC, however, is unknown.

Methods

A cost survey was conducted in Zamboanga Peninsula region in 2021 to estimate the economic and financial cost of implementing MDA compared to the expanded school-based targeted PC from a government payer perspective. A budget impact analysis was conducted to estimate the financial cost to the government of implementing MDA over a five-year timeframe. Monte Carlo simulation accounted for uncertainty in cost estimates. Costs were reported in 2021 United States Dollars ($).

Findings

The economic cost of MDA was $809,000 per year (95% CI: $679,000–$950,000) or $0.22 per person targeted (95% CI: $0.19–$0.26), while the expanded school-based targeted PC would cost $625,000 (95% CI: $549,000–$706,000) or $0.57 per person targeted (95% CI: $0.50–$0.64). Over five years, the financial cost to the government for MDA would be $3,113,000 (95% CI: $2,475,000–$3,810,000); $740,000 (95% CI: $486,000–$1,019,000) higher than expanded school-based targeted PC.

Interpretation

Implementing MDA in the region will increase the economic and financial costs by 29% and 31%, respectively, when compared to expanded school-based targeted PC. Implementing MDA would require the Department of Health to increase their total expenditure for STH control by 0.2% and could be key in addressing the ongoing STH burden.

Funding

The project was funded by the Australian Centre for the Control and Elimination of Neglected Tropical Diseases (NHMRC GA19028), and JPCDT was supported by a UNSW Scientia PhD Scholarship. SVN is funded by an NHMRC Investigator Grant (APP 2018220).

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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
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