A cost-effectiveness analysis of artemether lumefantrine for treatment of uncomplicated malaria in Zambia

Abstract

Background: Malaria remains a leading cause of morbidity, mortality and non-fatal disability in Zambia, especially among children, pregnant women and the poor. Data gathered by the National Malaria Control Centre has shown that recently observed widespread treatment failure of SP and chloroquine precipitated a surge in malaria-related morbidity and mortality. As a result, the Government has recently replaced chloroquine and SP with combination therapy as first-line treatment for malaria. Despite the acclaimed therapeutic advantages of ACTs over monotherapies with SP and CQ, the cost of ACTs is much greater, raising concerns about affordability in many poor countries such as Zambia. This study evaluates the costeffectiveness analysis of artemether-lumefantrine, a version of ACTs adopted in Zambia in mid 2004.

Evaluating the Treatment Costs for Uncomplicated Malaria at a Public Healthcare Facility in Nigeria and the Implications

“…The effect of variation of discount rates was examined in the sensitivity analysis. Building costs were estimated from office floor spaces, measured and valued on the basis of a standard cost per square meter land valuation measurement, and annualised over a useful 30-year period at a 3% discount rate [ 28 ]. Allocation of shared costs in joint offices was based on the proportion of malaria treatment.…”

Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012

“…Given that more than half of the population of Malawi lives below the national poverty level, and 71% lives on less than $1.90 a day [ 12 ], the cost of malaria treatment may be prohibitive for many households, potentially resulting in delayed care seeking and inadequate treatment [ 13 ]. Despite negotiated prices and subsidies, ACT remains more expensive than previous first-line medications such as sulfadoxine-pyrimethamine or chloroquine [ 14 ]. When direct payments for malaria care are removed, patients are significantly more likely to seek care for malaria episodes [ 15 ].…”

Cost–effectiveness of artemisinin combination therapy for uncomplicated malaria in children: data from Papua New Guinea

“…In a 2005 prospective observational study in Zambia, 6 the incremental cost-effectiveness ratio for A+L versus S+P was estimated at US$ 4.10 per case successfully treated from the health care provider's perspective. This is similar to the US$ 6.97 per success found in the present analyses.…”

“…5 Although choosing the right antimalarial treatment is crucial for effective management of uncomplicated infections, cost-effectiveness studies have been few. All the studies performed since the 1990s, when artemisinin combination therapy (ACT) became available, have focused on sub-Saharan Africa and India and on P. falciparum malaria [6][7][8][9][10] despite increasing recognition of the pathogenic importance of P. vivax. 11 Wide differences in the cost and efficacy of ACT regimens make comparative cost-effectiveness studies indispensable.…”