Economic burden of Chagas disease in Latin American countries: a population-based cost-of-illness analysis from the RAISE study

Abstract

Background Chagas disease (ChD) remains a public health concern in Latin America. Despite a decline in overall prevalence, the chronic symptomatic forms still impose a substantial epidemiological and economic burden. This study undertakes a comprehensive, population-based cost analysis of chronic Chagas disease (CCD) from a societal perspective in seven endemic Latin American countries for 2010 and 2023. Methods A Markov model with one-year cycles and six states was employed. Direct medical and indirect costs, converted to 2024 purchasing power parity US dollars, were estimated using prevalence data from the Global Burden of Disease Study 2023. Based on a previous Brazilian Markov model, parameters were adjusted using healthcare coverage and per capita health expenditure ratios for each country, further validated by national experts. Findings In 2010, Brazil (US$252 billion) and Argentina (US$164 billion) had the highest lifetime burdens. As a percentage of annual Gross Domestic Product, Bolivia (0⋅9%) and Argentina (0⋅8%) were most affected. CCD accounted for 6% of total health expenditures in both countries. Between 2010 and 2023, most countries experienced a decline in economic burden due to decreased CCD prevalence, despite an increased proportion of patients with cardiac conditions, reflecting population aging and disease progression