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[估计抗恰加斯病药物的需求:对拉丁美洲药物可及性的一项贡献]

[Estimating demand for anti-Chagas drugs: a contribution for access in Latin America].

作者信息

Chaves Gabriela Costa, Abi-Saab Arrieche Mariana, Rode Joelle, Mechali Daniel, Reis Priscileyne Ouverney, Alves Renato Vieira, Stobbaerts Eric, Aguilar Nora Girón, Ribeiro Isabela

机构信息

Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro Brasil.

Iniciativa Medicamentos para Enfermedades Olvidadas (DNDi, por sus siglas en inglés), Rio de Janeiro, Brasil.

出版信息

Rev Panam Salud Publica. 2017 Jun 8;41:e45. doi: 10.26633/RPSP.2017.45.

Abstract

OBJECTIVE

Describe a tool to estimate demand for benznidazole and nifurtimox to treat Chagas disease, and report on its implementation in a group of Latin American countries.

METHODS

The project was carried out in the following stages: 1) development of a tool to estimate demand, and definition of the evaluation and decision variables to estimate demand 2) data collection via a questionnaire completed by representatives of control programs, complemented with data from the literature; 3) presentation of the tool, followed by validation, and adaptation by representatives of the control programs in order to plan drug procurement for 2012 and 2013; and 4) further analysis of the obtained data, especially regarding benznidazole, and comparison of country estimates.

RESULTS

Fourteen endemic countries of Latin America took part in the third stage, and a consolidated estimate was made. The number of estimated treatments, based on the number of tablets per treatment established in the regimen of reference was: 867 in the group under 1 year of age; 2 042 835 in the group from 1 to 15 years old; 2 028 in the group from 15 to 20 years old; and 10 248 in adults over 20. This means that it is possible to provide benznidazole to less than 1% of people for whom treatment is indicated.

CONCLUSIONS

The development and systematic use of demand management tools can play a key role in helping to provide access to the anti-Chagas drugs. There is a significant gap between the projected demand for drugs and current estimates of prevalence rates.

摘要

目的

描述一种用于估算治疗恰加斯病所需苯硝唑和硝呋莫司需求量的工具,并报告其在一组拉丁美洲国家的实施情况。

方法

该项目按以下阶段开展:1)开发一种估算需求的工具,并确定估算需求的评估和决策变量;2)通过控制项目代表填写的问卷收集数据,并辅以文献数据;3)展示该工具,随后进行验证,并由控制项目代表进行调整,以便为2012年和2013年的药品采购制定计划;4)对获得的数据进行进一步分析,特别是关于苯硝唑的数据,并比较各国的估算值。

结果

拉丁美洲的14个流行国家参与了第三阶段,并进行了综合估算。根据参考方案中确定的每次治疗片剂数量估算的治疗次数为:1岁以下组867次;1至15岁组2042835次;15至20岁组2028次;20岁以上成年人组10248次。这意味着能够为不到1%的有治疗指征的人提供苯硝唑。

结论

需求管理工具的开发和系统使用在帮助提供抗恰加斯病药物方面可发挥关键作用。预计的药物需求量与目前的患病率估算值之间存在显著差距。

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