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Impact of treatment heterogeneity on drug resistance and supply chain costs.

Spiliotopoulou E, Boni MF, Yadav P - Socioecon Plann Sci (2013)

Bottom Line: Using a model for disease transmission and resistance spread, we show that treatment with multiple drugs, on a population level, results in better resistance-related health outcomes, but more interestingly, the marginal benefit decreases as the number of drugs used increases.We compare this benefit with the corresponding change in procurement and safety stock holding costs that result from higher drug variety in the supply chain.Using a large-scale simulation based on malaria transmission dynamics, we show that disease prevalence seems to be a less important factor when deciding the optimal width of drug assortment, compared to the duration of one episode of the disease and the price of the drug(s) used.

View Article: PubMed Central - PubMed

Affiliation: MIT-Zaragoza International Logistics Program, Zaragoza Logistics Center, Zaragoza 50197, Spain.

ABSTRACT

The efficacy of scarce drugs for many infectious diseases is threatened by the emergence and spread of resistance. Multiple studies show that available drugs should be used in a socially optimal way to contain drug resistance. This paper studies the tradeoff between risk of drug resistance and operational costs when using multiple drugs for a specific disease. Using a model for disease transmission and resistance spread, we show that treatment with multiple drugs, on a population level, results in better resistance-related health outcomes, but more interestingly, the marginal benefit decreases as the number of drugs used increases. We compare this benefit with the corresponding change in procurement and safety stock holding costs that result from higher drug variety in the supply chain. Using a large-scale simulation based on malaria transmission dynamics, we show that disease prevalence seems to be a less important factor when deciding the optimal width of drug assortment, compared to the duration of one episode of the disease and the price of the drug(s) used. Our analysis shows that under a wide variety of scenarios for disease prevalence and drug cost, it is optimal to simultaneously deploy multiple drugs in the population. If the drug price is high, large volume purchasing discounts are available, and disease prevalence is high, it may be optimal to use only one drug. Our model lends insights to policy makers into the socially optimal size of drug assortment for a given context.

No MeSH data available.


Related in: MedlinePlus

Medium endemicity: Relevant costs as a function of drugs employed for different drug cost parameters (price, volume discount, fixed cost).
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fig5: Medium endemicity: Relevant costs as a function of drugs employed for different drug cost parameters (price, volume discount, fixed cost).

Mentions: From the analysis in Section 4, it becomes apparent that the behavior of supply chain costs depends heavily on the discount scheme and the fixed cost per supplier per period. For medium endemicity setting and t = 15, Fig. 5 presents how the various cost elements behave as a function of n when the price of the drug is high, when there are high volume discounts and when the fixed cost per supplier is very large.


Impact of treatment heterogeneity on drug resistance and supply chain costs.

Spiliotopoulou E, Boni MF, Yadav P - Socioecon Plann Sci (2013)

Medium endemicity: Relevant costs as a function of drugs employed for different drug cost parameters (price, volume discount, fixed cost).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4375612&req=5

fig5: Medium endemicity: Relevant costs as a function of drugs employed for different drug cost parameters (price, volume discount, fixed cost).
Mentions: From the analysis in Section 4, it becomes apparent that the behavior of supply chain costs depends heavily on the discount scheme and the fixed cost per supplier per period. For medium endemicity setting and t = 15, Fig. 5 presents how the various cost elements behave as a function of n when the price of the drug is high, when there are high volume discounts and when the fixed cost per supplier is very large.

Bottom Line: Using a model for disease transmission and resistance spread, we show that treatment with multiple drugs, on a population level, results in better resistance-related health outcomes, but more interestingly, the marginal benefit decreases as the number of drugs used increases.We compare this benefit with the corresponding change in procurement and safety stock holding costs that result from higher drug variety in the supply chain.Using a large-scale simulation based on malaria transmission dynamics, we show that disease prevalence seems to be a less important factor when deciding the optimal width of drug assortment, compared to the duration of one episode of the disease and the price of the drug(s) used.

View Article: PubMed Central - PubMed

Affiliation: MIT-Zaragoza International Logistics Program, Zaragoza Logistics Center, Zaragoza 50197, Spain.

ABSTRACT

The efficacy of scarce drugs for many infectious diseases is threatened by the emergence and spread of resistance. Multiple studies show that available drugs should be used in a socially optimal way to contain drug resistance. This paper studies the tradeoff between risk of drug resistance and operational costs when using multiple drugs for a specific disease. Using a model for disease transmission and resistance spread, we show that treatment with multiple drugs, on a population level, results in better resistance-related health outcomes, but more interestingly, the marginal benefit decreases as the number of drugs used increases. We compare this benefit with the corresponding change in procurement and safety stock holding costs that result from higher drug variety in the supply chain. Using a large-scale simulation based on malaria transmission dynamics, we show that disease prevalence seems to be a less important factor when deciding the optimal width of drug assortment, compared to the duration of one episode of the disease and the price of the drug(s) used. Our analysis shows that under a wide variety of scenarios for disease prevalence and drug cost, it is optimal to simultaneously deploy multiple drugs in the population. If the drug price is high, large volume purchasing discounts are available, and disease prevalence is high, it may be optimal to use only one drug. Our model lends insights to policy makers into the socially optimal size of drug assortment for a given context.

No MeSH data available.


Related in: MedlinePlus