Estimating demand for anti-Chagas drugs: a contribution for access in Latin America/Estimacion de la demanda de medicamentos antichagasicos: una contribucion para el acceso en America Latina/Estimativa da demanda de medicamentos antichagasicos: uma contribuicao para o acesso na America Latina

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. Keywords Neglected diseases; Chagas disease; equity in access; drugs, essential. Objetivo. Describir una herramienta de estimacion de la demanda de benznidazol y nifurtimox para la enfermedad de Chagas y relatar su aplicacion en un conjunto de paises de America Latina. Metodos. El proyecto se desarrollo en las siguientes etapas: 1) elaboracion de una herramienta y definicion de las variables de evaluacion y decision para estimacion de la demanda, 2) recoleccion de datos a partir de un cuestionario a representantes de programas de control, complementado con datos de la literatura, 3) presentacion, validacion y adaptacion de la herramienta por representantes de los programas de control, con la intencion de planificar la adquisicion de medicamentos para los anos de 2012 y 2013, y 4) analisis complementar de los datos obtenidos, en especial benznidazol, y comparacion de las estimaciones de los paises. Resultados. Catorce paises endemicos