An economic evaluation of the posttreatment prophylactic effect of dihydroartemisinin-piperaquine versus artemether-lumefantrine for first-line treatment of plasmodium falciparum malaria across different transmission settings in Africa

Johannes Pfeil, Steffen Borrmann, Quique Bassat, Modest Mulenga, Ambrose Talisuna, Yesim Tozan

Research output: Contribution to journalArticle

Abstract

Malaria disproportionately affects young children. Clinical trials inAfrican children showed that dihydroartemisinin-piperaquine (DP) is an effective antimalarial and has a longer posttreatment prophylactic (PTP) effect against reinfections than other artemisinin-based combination therapies, including artemether-lumefantrine (AL). Using a previously developed Markov model and individual patient data from a multicenter African drug efficacy trial, we assessed the economic value of the PTP effect of DP versus AL in pediatric malaria patients from health-care provider's perspective in lowto-moderate and moderate-to-high transmission settings under different drug co-payment scenarios. In low-to-moderate transmission settings, first-line treatment with DP was highly cost-effective with an incremental cost-effectiveness ratio of US5 (95% confidence interval [CI] = ?76 to 196) per disability-adjusted life year (DALY) averted. In moderate-to-high transmission settings, DP first-line treatment led to a mean cost saving of US1.09 (95% CI = ?0.88 to 3.85) and averted 0.05 (95% CI = ?0.08 to 0.22) DALYs per child per year. Our results suggested that DP might be superior to AL for first-line treatment of uncomplicated childhood malaria across a range of transmission settings in Africa.

Original languageEnglish (US)
Pages (from-to)961-966
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume93
Issue number5
DOIs
StatePublished - Nov 4 2015

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dihydroartemisinin
Falciparum Malaria
Cost-Benefit Analysis
Malaria
Confidence Intervals
Therapeutics
Costs and Cost Analysis
Quality-Adjusted Life Years
Antimalarials
Pharmaceutical Preparations
Health Personnel
Patient Care
Economics
artemether
lumefantrine
piperaquine
Clinical Trials
Pediatrics

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

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title = "An economic evaluation of the posttreatment prophylactic effect of dihydroartemisinin-piperaquine versus artemether-lumefantrine for first-line treatment of plasmodium falciparum malaria across different transmission settings in Africa",
abstract = "Malaria disproportionately affects young children. Clinical trials inAfrican children showed that dihydroartemisinin-piperaquine (DP) is an effective antimalarial and has a longer posttreatment prophylactic (PTP) effect against reinfections than other artemisinin-based combination therapies, including artemether-lumefantrine (AL). Using a previously developed Markov model and individual patient data from a multicenter African drug efficacy trial, we assessed the economic value of the PTP effect of DP versus AL in pediatric malaria patients from health-care provider's perspective in lowto-moderate and moderate-to-high transmission settings under different drug co-payment scenarios. In low-to-moderate transmission settings, first-line treatment with DP was highly cost-effective with an incremental cost-effectiveness ratio of US5 (95{\%} confidence interval [CI] = ?76 to 196) per disability-adjusted life year (DALY) averted. In moderate-to-high transmission settings, DP first-line treatment led to a mean cost saving of US1.09 (95{\%} CI = ?0.88 to 3.85) and averted 0.05 (95{\%} CI = ?0.08 to 0.22) DALYs per child per year. Our results suggested that DP might be superior to AL for first-line treatment of uncomplicated childhood malaria across a range of transmission settings in Africa.",
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AU - Borrmann, Steffen

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AU - Talisuna, Ambrose

AU - Tozan, Yesim

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