Benznidazole therapy is cost-saving compared with no treatment for indeterminate chronic Chagas disease in the...

Chagas disease is increasingly prevalent in Europe, but the main treatment available, benznidazole, is still under-used. This study aimed to assess the cost-effectiveness of benznidazole for chronic indeterminate Chagas disease in a Spanish setting from the perspective of the healthcare system, with a 20-year time horizon.

The study took place in the publicly funded Spanish health system. The model was specifically calibrated to reflect the Spanish epidemiological situation. An economic evaluation (cost-effectiveness analysis) was performed using a Markov model and Monte Carlo simulations and probabilistic sensitivity analysis to characterise uncertainty. Key input data included transition probabilities (derived and calibrated from the literature) and costs.

The model projects that treating Chagas disease with benznidazole would yield approximately 713 758 quality-adjusted life-years (QALYs) at a total cost of €1 billion over 20 years, whereas the usual follow-up care would generate 704 580 QALYs at €1.57 billion. Thus, benznidazole confers an additional 9.177 QALYs while saving roughly €569 million, indicating that Benznidazole is more effective and less costly (i.e. dominant) compared with no treatment. The expected value of perfect information was calculated at €0.83 million per year over the study period.

Benznidazole appears to be a cost-saving treatment for patients with chronic indeterminate Chagas disease in the studied healthcare setting. Although some residual uncertainty exists, the results suggest that investing in future research to reduce this uncertainty would be reasonable, up to the calculated expected value of perfect information value. Benznidazole cost should not hinder access for eligible patients.