Document 1190
 DOCN  M9591190
 TI    Drug therapies for sexually transmitted diseases. Clinical and economic
       considerations.
 DT    9509
 AU    Bowie WR; Division of Infectious Diseases, Faculty of Medicine,
       University; of British Columbia, Vancouver, Canada.
 SO    Drugs. 1995 Apr;49(4):496-515. Unique Identifier : AIDSLINE MED/95309138
 AB    Sexually transmitted diseases (STDs) are common, and result in immense
       social and economic costs. In some countries they have a major
       demographic impact. Because many STDs facilitate the transmission of
       HIV, the consequences of STDs are further increasing. At the same time,
       this association between STDs and HIV provides one of the ways in which
       drug therapy should be very cost effective. The perspective taken in
       this article is a societal one, and broader issues than those directly
       related to drug costs and benefits are discussed. However, it is the
       availability of drugs that has the potential to most quickly and most
       reliably make a major difference to overall health sector and societal
       costs as they relate to STDs. For those STDs for which curative therapy
       is available (particularly Neisseria gonorrhoeae, Chlamydia trachomatis,
       Treponema pallidum, and Trichomonas vaginalis) there have been large
       decreases in prevalence in many parts of the world. In contrast, those
       STDs for which curative therapy is not available (particularly HIV,
       genital herpes and genital human papillomavirus infection) have had
       stable or increasing prevalence. For these latter infections, each new
       case increases the overall prevalence. Numerous features of STDs make
       clinical and economic evaluation difficult. These include the sensitive
       nature of the topic, the changing epidemiology and drug susceptibility
       of individual STDs, the fact that a large proportion of those infected
       are asymptomatic, difficulties in making specific diagnoses, the fact
       that often consequences are recognised late, sexual re-exposure and
       reinfection, and inadequate data on which to do clinical and economic
       evaluations. Furthermore, risk of acquiring an STD roughly correlates
       inversely with socioeconomic status, and countries or places with the
       highest rates of STDs may have the least ability to deal effectively
       with their diagnosis and management. Most of the direct and indirect
       costs are incurred by women, since they experience the vast majority of
       the complications of STDs. Many of these only become apparent years
       later, which makes it very hard to attribute costs and benefits to a
       specific episode of infection, and to its treatment. The late and
       indirect costs, plus the costs of prevention, are hard to quantify. That
       the major burden of STDs is in adolescents and young adults,
       socioeconomically disadvantaged groups and women has important
       implications, including for pharmacoeconomic studies.(ABSTRACT TRUNCATED
       AT 400 WORDS)
 DE    Anti-Infective Agents/ECONOMICS/*THERAPEUTIC USE  Economics,
       Pharmaceutical  Female  Health Care Costs  Human  Male  Quality of Life
       Sexually Transmitted Diseases/*DRUG THERAPY/ECONOMICS/  EPIDEMIOLOGY
       Socioeconomic Factors  Treatment Outcome  JOURNAL ARTICLE  REVIEW
       REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).