Cost-effectiveness of artesunate for the treatment of severe malaria

• Published in: Tropical medicine & international health Vol. 14; no. 3; pp. 332 - 337
• Main Authors: Lubell, Y, Yeung, S, Dondorp, A.M, Day, N.P, Nosten, F, Tjitra, E, Abul Faiz, Md, Bin Yunus, E, Anstey, N.M, Mishra, S.K, Mohanty, S, White, N.J, Mills, A.J
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01-03-2009; Blackwell Publishing Ltd; Blackwell
• Subjects: Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimalarials - economics; Antimalarials - therapeutic use; Antiparasitic agents; artemisinin; artemisinina; Artemisinins - economics; Artemisinins - therapeutic use; artesunate; artesunato; artémisinine; artésunate; Asia, Southeastern - epidemiology; Biological and medical sciences; Clinical trials; Comparative studies; cost; Cost-Benefit Analysis; coste; costs and returns; coût; Drug Costs - statistics & numerical data; Drug therapy; economic; economics; económico; General aspects; Health Care Costs - statistics & numerical data; Health care expenditures; Human protozoal diseases; Humans; Infectious diseases; Malaria; Malaria - drug therapy; Malaria - economics; Malaria - mortality; Medical sciences; Mortality; Parasitic diseases; Pharmacology. Drug treatments; Protozoal diseases; quinina; quinine; Quinine - economics; Quinine - therapeutic use; Treatment Outcome; économique; Asia, Southeastern; Southeast Asia; Asia; Antimalarial; Protozoal disease; Costs; cost; Malaria; Artemisinin; Parasitosis; Quinine; Infection; Treatment; Health economy; Artesunate; Antipyretic; Parasiticide; Tropical medicine; Public health; economic; Cost efficiency analysis
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/j.1365-3156.2009.02227.x

To explore the cost-effectiveness of artesunate against quinine based principally on the findings of a large multi-centre trial carried out in Southeast Asia. Trial data were used to compare mortality of patients with severe malaria, treated with either artesunate or quinine. This was combined with retrospectively collected cost data to estimate the incremental cost per death averted with the use of artesunate instead of quinine. The incremental cost per death averted using artesunate was approximately 140 USD. Artesunate maintained this high level of cost-effectiveness also when allowing for the uncertainty surrounding the cost and effectiveness assessments. This analysis confirms the vast superiority of artesunate for treatment of severe malaria from an economic as well as a clinical perspective.