Terapia con benzonidazol es ahorro de costos en comparación con la no intervención para la enfermedad de Chagas crónica indeterminada en el entorno sanitario español

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 (PSA) 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 about 713 758 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 (EVPI) was calculated at €0·83 million per year over the study period.

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