Cost-Effectiveness of a Chemoprophylactic Intervention with Single Dose Rifampicin in Contacts of New Leprosy Patients

In 2008, 249,007 new leprosy patients were detected in the world. It therefore remains necessary to develop new and effective interventions to interrupt the transmission of M. leprae. We assessed the economic benefits of single dose rifampicin (SDR) for contacts as chemoprophylactic intervention in the control of leprosy. The study is based on a large trial including 21,711 contacts of 1,037 patients with newly diagnosed leprosy. We gave a single dose of rifampicin or placebo to contacts and followed them up for four years. The main outcome measure was the development of clinical leprosy. The cost effectiveness was expressed in US dollars per prevented leprosy case. Chemoprophylaxis with SDR for preventing leprosy among contacts of leprosy patients is cost-effective at all contact levels and thereby a cost-effective prevention strategy. In total $6,009 was invested and 38 leprosy cases were prevented after 2 years, costing$158 per prevented leprosy case. Implementation studies are necessary to establish whether this intervention is acceptable and feasible in other leprosy endemic areas of the world

Number of leprosy patients arising from contacts after 2 years according to physical distance of the contacts to the index patient, by intervention (standard treatment <i>vs.</i> chemoprophylaxis).

<p>Number of leprosy patients arising from contacts after 2 years according to physical distance of the contacts to the index patient, by intervention (standard treatment <i>vs.</i> chemoprophylaxis).</p

Summary of total costs in the two treatment arms (in US$).

<p>Summary of total costs in the two treatment arms (in US$).</p

Model structure to calculate benefits (newly diagnosed leprosy patients) and costs of chemoprophylaxis with single dose rifampicin.

<p>Model structure to calculate benefits (newly diagnosed leprosy patients) and costs of chemoprophylaxis with single dose rifampicin.</p