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76 THIRD WHO REPORT ON NEGLECTED TROPICAL DISEASES
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Investment case
The cost of Chagas disease was estimated in 2013 at more than US$ 7 (4–11) billion per
year, including lost productivity. 1 Cost-of-illness studies including productivity losses
must be interpreted with caution, especially when comparing them with those for other
diseases, as they are often highly sensitive to methodological assumptions. Nonetheless,
health-care costs alone were estimated at US$ 0.6 (0.2–1.6) billion per year. Of note is
that almost one-fifth of health-care costs are estimated to have been incurred outside the
endemic countries. The cost of treatment ranges from less than US$ 200 to more than
US$ 30 000 per person per year in endemic countries, and exceeds US$ 40 000 in the
USA (forthcoming review of the literature). In Mexico, the cost – including diagnosis,
Investment targets for vector control against Chagas disease (attack phase
and sustained surveillance), 2015–2030
1500
Constant US$ millions
1000
500
0
2015
2020
Year
2025
2030
Notes: Shaded areas reflect the range determined by low and high values of the unit cost benchmarks; they do not
reflect uncertainty about future rates of scale-up and scale-down of interventions. All numbers expressed in US$ are
constant (real) US$, adjusted to reflect purchasing power in the United States of America in 2015.
treatment and productivity losses – may increase more than 20-fold from an acute case to a
chronic case. 2 In Brazil, the cost of hospitalization for chagasic cardiomyopathy with heart
failure has been estimated at an average of US$ 467 per day – higher than for non-chagasic
admissions with heart failure. 3
A better understanding of the costs and effects of prevention may help create incentives for
increased collaboration between endemic and non-endemic countries, including for both
prevention of infection (primary prevention) and early detection of infection (secondary
prevention). This report addresses primary prevention through vector control strategies
in endemic countries, given the available evidence of its cost-effectiveness. In 2006, the
second edition of the Disease Control Priorities Project put the cost per DALY averted by
vector control at less than US$ 300 based on a study from Brazil. More recent economic
evaluations put the cost of the most cost–effective vector control interventions at less than
US$ 200 per household per year and less than US$ 200 per case averted in Argentina. 4