Cost-effectiveness analysis of malaria chemoprophylaxis for travellers to West-Africa

BMC Infectious Diseases

Research Article

Koen Van Herck¹  Patricia R Blank²  Patricia Schlagenhauf³  Christoph Hatz³  Lukas L Widmer³ 

[1] Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Campus Drie Eiken (R2.17b), Universiteitsplein 1, B-2610, Antwerp, Belgium;Institute of Social and Preventive Medicine, Departement of Health Economics, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland;WHO Collaborating Centre for Travellers' Health, University of Zürich Centre for Travel Medicine, Hirschengraben 84, 8001, Zürich, Switzerland;

关键词: Malaria;    Malaria Case;    Mefloquine;    Incremental Cost Effectiveness Ratio;    Reimbursement Strategy;   

DOI  :  10.1186/1471-2334-10-279

 received in 2009-11-23, accepted in 2010-09-22,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe importation of malaria to non-endemic countries remains a major cause of travel-related morbidity and a leading cause of travel-related hospitalizations. Currently they are three priority medications for malaria prophylaxis to West Africa: mefloquine, atovaquone/proguanil and doxycycline. We investigate the cost effectiveness of a partial reimbursement of the cheapest effective malaria chemoprophylaxis (mefloquine) for travellers to high risk areas of malaria transmission compared with the current situation of no reimbursement.MethodsThis study is a cost-effectiveness analysis based on malaria cases imported from West Africa to Switzerland from the perspective of the Swiss health system. We used a decision tree model and made a literature research on the components of travel related malaria. The main outcome measure was the cost effectiveness of malaria chemoprophylaxis reimbursement based on malaria and deaths averted.ResultsUsing a program where travellers would be reimbursed for 80% of the cost of the cheapest malaria chemoprophylaxis is dominant (i.e. cost saving and more effective than the current situation) using the assumption that currently 68.7% of travellers to West Africa use malaria chemoprophylaxis. If the current usage of malaria chemoprophylaxis would be higher, 82.4%, the incremental cost per malaria case averted is € 2'302. The incremental cost of malaria death averted is € 191'833.The most important factors influencing the model were: the proportion of travellers using malaria chemoprophylaxis, the probability of contracting malaria without malaria chemoprophylaxis, the cost of the mefloquine regimen, the decrease in the number of travellers without malaria chemoprophylaxis in the reimbursement strategy.ConclusionsThis study suggests that a reimbursement of 80% of the cost of the cheapest effective malaria chemoprophylaxis (mefloquine) for travellers from Switzerland to West Africa is highly effective in terms of malaria cases averted and is cost effective to the Swiss health system. These data are relevant to discussions about the cost effectiveness of malaria chemoprophylaxis reimbursement for vulnerable groups such as those visiting friends and relatives who have the highest risk of malaria, who are least likely to use chemoprophylaxis.

【 授权许可】

Unknown   
© Widmer et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.