Cost-effectiveness of dihydroartemisinin-piperaquine compared with artemether-lumefantrine for treating uncomplicated malaria in children at a district hospital in Tanzania

Malaria Journal

Research

Bjarne Robberstad¹  Ole F Norheim¹  Frida Ngalesoni²  Amani T Mori³ 

[1] Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway;Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway;Ministry of Health and Social Welfare, P.O. Box 9083, Dar es Salaam, Tanzania;Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway;Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania;

关键词: Tanzania;    Dihydroartemisinin-piperaquine;    Artemether-lumefantrine;    Malaria;    Cost-effectiveness;    Markov model;    Disability adjusted life years;   

DOI  :  10.1186/1475-2875-13-363

 received in 2014-06-07, accepted in 2014-09-12,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundDihydroartemisinin-piperaquine (DhP) is highly recommended for the treatment of uncomplicated malaria. This study aims to compare the costs, health benefits and cost-effectiveness of DhP and artemether-lumefantrine (AL) alongside “do-nothing” as a baseline comparator in order to consider the appropriateness of DhP as a first-line anti-malarial drug for children in Tanzania.MethodsA cost-effectiveness analysis was performed using a Markov decision model, from a provider’s perspective. The study used cost data from Tanzania and secondary effectiveness data from a review of articles from sub-Saharan Africa. Probabilistic sensitivity analysis was used to incorporate uncertainties in the model parameters. In addition, sensitivity analyses were used to test plausible variations of key parameters and the key assumptions were tested in scenario analyses.ResultsThe model predicts that DhP is more cost-effective than AL, with an incremental cost-effectiveness ratio (ICER) of US$ 12.40 per DALY averted. This result relies on the assumption that compliance to treatment with DhP is higher than that with AL due to its relatively simple once-a-day dosage regimen. When compliance was assumed to be identical for the two drugs, AL was more cost-effective than DhP with an ICER of US$ 12.54 per DALY averted. DhP is, however, slightly more likely to be cost-effective compared to a willingness-to-pay threshold of US$ 150 per DALY averted.ConclusionDihydroartemisinin-piperaquine is a very cost-effective anti-malarial drug. The findings support its use as an alternative first-line drug for treatment of uncomplicated malaria in children in Tanzania and other sub-Saharan African countries with similar healthcare infrastructures and epidemiology of malaria.

【 授权许可】

CC BY   
© Mori et al.; licensee BioMed Central Ltd. 2014