PMID: 11926003Apr 3, 2002Paper

An economic comparison of chloroquine and sulfadoxine-pyrimethamine as first-line treatment for malaria in South Africa: development of a model for estimating recurrent direct costs

Transactions of the Royal Society of Tropical Medicine and Hygiene
J J WilkinsK I Barnes

Abstract

The relative cost-effectiveness of chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) as first-line antimalarial therapy in southern Africa is of great interest to policymakers, clinicians and researchers in the subregion. A model was developed to access the cost-effectiveness of replacing CQ with SP as first-line treatment in Mpumalanga, South Africa, where malaria is seasonal and the population is non-immune. In-vivo drug resistance levels were used to derive a 'resistance variable' for each drug, which was used to compare the costs to the public healthcare provider associated with either therapeutic option. Costs including drugs, staff time, transport, maintenance, utilities, training and consumables were determined and subjected to Monte Carlo simulation and subsequent analysis to generate an average cost-effectiveness ratio (ACER) with confidence intervals for each drug. SP was found to be 4.8 (95% CI 3.3-6.7) times more cost-effective than CQ in Mpumalanga at 1997 resistance levels and costs, despite the far greater cost per treatment course of SP (US$ 4.02 as opposed to US$ 0.22 for CQ) in South Africa. At the price of SP in Kenya and Uganda (US$ 0.47-4.80 per treatment course), the ACER for SP does not change materiall...Continue Reading

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Citations

Jul 20, 2004·Clinical Microbiology Reviews·Peter WinstanleyAlasdair Breckenridge
Jan 10, 2009·Cost Effectiveness and Resource Allocation : C/E·Zana C SomdaIdrissa Sow
Jul 20, 2012·PharmacoEconomics·Paul GavazaStar Khoza
May 16, 2008·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Jeffrey S Hoch, Carolyn S Dewa

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