IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0012223.html
   My bibliography  Save this article

Cost Effectiveness of Seasonal Intermittent Preventive Treatment Using Amodiaquine & Artesunate or Sulphadoxine-Pyrimethamine in Ghanaian Children

Author

Listed:
  • Lesong Conteh
  • Edith Patouillard
  • Margaret Kweku
  • Rosa Legood
  • Brian Greenwood
  • Daniel Chandramohan

Abstract

Background: Intermittent preventive treatment for malaria in children (IPTc) involves the administration of a full course of an anti-malarial treatment to children under 5 years old at specified time points regardless of whether or not they are known to be infected, in areas where malaria transmission is seasonal. It is important to determine the costs associated with IPTc delivery via community based volunteers and also the potential savings to health care providers and caretakers due to malaria episodes averted as a consequence of IPTc. Methods: Two thousand four hundred and fifty-one children aged 3–59 months were randomly allocated to four groups to receive: three days of artesunate plus amodiaquine (AS+AQ) monthly, three days of AS+AQ bimonthly, one dose of sulphadoxine-pyrimethamine (SP) bi-monthly or placebo. This paper focuses on incremental cost effectiveness ratios (ICERs) of the three IPTc drug regimens as delivered by community based volunteers (CBV) in Hohoe, Ghana compared to current practice, i.e. case management in the absence of IPTc. Financial and economic costs from the publicly funded health system perspective are presented. Treatment costs borne by patients and their caretakers are also estimated to present societal costs. The costs and effects of IPTc during the intervention period were considered with and without a one year follow up. Probabilistic sensitivity analysis was undertaken to account for uncertainty. Results: Economic costs per child receiving at least the first dose of each course of IPTc show SP bimonthly, at US$8.19, is the cheapest to deliver, followed by AS+AQ bimonthly at US$10.67 and then by AS+AQ monthly at US$14.79. Training, drug delivery and supervision accounted for approximately 20–30% each of total unit costs. During the intervention period AS & AQ monthly was the most cost effective IPTc drug regimen at US$67.77 (61.71–74.75, CI 95%) per malaria case averted based on intervention costs only, US$64.93 (58.92–71.92, CI 95%) per malaria case averted once the provider cost savings are included and US$61.00 (54.98, 67.99, CI 95%) when direct household cost savings are also taken into account. SP bimonthly was US$105.35 (75.01–157.31, CI 95%) and AS & AQ bimonthly US$211.80 (127.05–399.14, CI 95%) per malaria case averted based on intervention costs only. The incidence of malaria in the post intervention period was higher in children who were

Suggested Citation

  • Lesong Conteh & Edith Patouillard & Margaret Kweku & Rosa Legood & Brian Greenwood & Daniel Chandramohan, 2010. "Cost Effectiveness of Seasonal Intermittent Preventive Treatment Using Amodiaquine & Artesunate or Sulphadoxine-Pyrimethamine in Ghanaian Children," PLOS ONE, Public Library of Science, vol. 5(8), pages 1-11, August.
    • Handle: RePEc:plo:pone00:0012223
    DOI: 10.1371/journal.pone.0012223
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0012223
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0012223&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0012223?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Milton C. Weinstein & Joanna E. Siegel & Alan M. Garber & Joseph Lipscomb & Bryan R. Luce & Willard G. Manning & George W. Torrance, 1997. "Productivity costs, time costs and health‐related quality of life: a response to the Erasmus Group," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 505-510, September.
    2. Asenso-Okyere, W. K. & Dzator, Janet A., 1997. "Household cost of seeking malaria care. A retrospective study of two districts in Ghana," Social Science & Medicine, Elsevier, vol. 45(5), pages 659-667, September.
    3. Robert W. Snow & Carlos A. Guerra & Abdisalan M. Noor & Hla Y. Myint & Simon I. Hay, 2005. "The global distribution of clinical episodes of Plasmodium falciparum malaria," Nature, Nature, vol. 434(7030), pages 214-217, March.
    4. Werner B.F. Brouwer & Marc A. Koopmanschap & Frans F.H. Rutten, 1997. "Productivity costs in cost‐effectiveness analysis: numerator or denominator: a further discussion," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 511-514, September.
    5. Morel, Chantal M. & Ngo Duc, Thang & Nguyen, Xuan Xa & Le Xuan, Hung & Le Khan, Thuan & Pham, Van Ky & Erhart, Annette & Mills, Anne J. & D'Alessandro, Umberto, 2008. "The economic burden of malaria on the household in south-central Vietnam," LSE Research Online Documents on Economics 28558, London School of Economics and Political Science, LSE Library.
    6. Koopmanschap, Marc A. & Rutten, Frans F. H. & van Ineveld, B. Martin & van Roijen, Leona, 1995. "The friction cost method for measuring indirect costs of disease," Journal of Health Economics, Elsevier, vol. 14(2), pages 171-189, June.
    7. Peter Doubilet & Colin B. Begg & Milton C. Weinstein & Peter Braun & Barbara J. McNeil, 1985. "Probabilistic Sensitivity Analysis Using Monte Carlo Simulation," Medical Decision Making, , vol. 5(2), pages 157-177, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Hamma Maiga & Jean Gaudart & Issaka Sagara & Modibo Diarra & Amadou Bamadio & Moussa Djimde & Samba Coumare & Boubou Sangare & Yeyia Dicko & Aly Tembely & Djibril Traore & Alassane Dicko & Estrella La, 2020. "Two-Year Scale-Up of Seasonal Malaria Chemoprevention Reduced Malaria Morbidity among Children in the Health District of Koutiala, Mali," IJERPH, MDPI, vol. 17(18), pages 1-10, September.
    2. Edith Patouillard & Lesong Conteh & Jayne Webster & Margaret Kweku & Daniel Chandramohan & Brian Greenwood, 2011. "Coverage, Adherence and Costs of Intermittent Preventive Treatment of Malaria in Children Employing Different Delivery Strategies in Jasikan, Ghana," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-9, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Brouwer, W. B. F. & van Exel, N. J. A. & Koopmanschap, M. A. & Rutten, F. F. H., 2002. "Productivity costs before and after absence from work: as important as common?," Health Policy, Elsevier, vol. 61(2), pages 173-187, August.
    2. Brouwer, Werner B. F. & Koopmanschap, Marc A., 2000. "On the economic foundations of CEA. Ladies and gentlemen, take your positions!," Journal of Health Economics, Elsevier, vol. 19(4), pages 439-459, July.
    3. Carmen Herrero Blanco & Juan D. Moreno Ternero, 2004. "Generalized Cost-Analysis Of Screening Programs," Working Papers. Serie AD 2004-18, Instituto Valenciano de Investigaciones Económicas, S.A. (Ivie).
    4. Chima, Reginald Ikechukwu & Goodman, Catherine A. & Mills, Anne, 2003. "The economic impact of malaria in Africa: a critical review of the evidence," Health Policy, Elsevier, vol. 63(1), pages 17-36, January.
    5. Tilling, C & Krol, M & Tsuchiya, A & Brazier, J & van Exel, J & Brouwer, W, 2009. "The impact of losses in income due to ill health: does the EQ-5D reflect lost earnings?," MPRA Paper 29837, University Library of Munich, Germany.
    6. Hanly, Paul & Ortega Ortega, Marta & Pearce, Alison & Soerjomataram, Isabelle & Sharp, Linda, 2020. "Advances in the methodological approach to friction period estimation: A European perspective," Social Science & Medicine, Elsevier, vol. 264(C).
    7. Carmen Herrero & Juan D. Moreno‐Ternero, 2009. "Estimating production costs in the economic evaluation of health‐care programs," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 21-35, January.
    8. Catherine A. Goodman & Paul G. Coleman & Anne J. Mills, 2001. "Changing the first line drug for malaria treatment—cost‐effectiveness analysis with highly uncertain inter‐temporal trade‐offs," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 731-749, December.
    9. Weatherly, Helen & Drummond, Michael & Claxton, Karl & Cookson, Richard & Ferguson, Brian & Godfrey, Christine & Rice, Nigel & Sculpher, Mark & Sowden, Amanda, 2009. "Methods for assessing the cost-effectiveness of public health interventions: Key challenges and recommendations," Health Policy, Elsevier, vol. 93(2-3), pages 85-92, December.
    10. Clive Pritchard;Martin Sculpher, 2000. "Productivity Costs: Principles and Practice in Economic Evaluation," Monograph 000464, Office of Health Economics.
    11. Werner B.F. Brouwer & Frans F.H. Rutten, 2003. "The missing link: on the line between C and E," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 629-636, August.
    12. Christopher McCabe, 2019. "Expanding the Scope of Costs and Benefits for Economic Evaluations in Health: Some Words of Caution," PharmacoEconomics, Springer, vol. 37(4), pages 457-460, April.
    13. John A. Nyman, 2012. "Productivity Costs Revisited: Toward A New Us Policy," Health Economics, John Wiley & Sons, Ltd., vol. 21(12), pages 1387-1401, December.
    14. Hansen, Kristian S. & Moreno-Ternero, Juan D. & Østerdal, Lars P., 2023. "Productivity and quality-adjusted life years: QALYs, PALYs and beyond," Working Papers 11-2023, Copenhagen Business School, Department of Economics.
    15. Jeff Richardson & Stuart Peacock & Angelo Iezzi, 2009. "Do quality-adjusted life years take account of lost income? Evidence from an Australian survey," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(1), pages 103-109, February.
    16. Krol, Marieke & Brouwer, Werner B.F. & Severens, Johan L. & Kaper, Janneke & Evers, Silvia M.A.A., 2012. "Productivity cost calculations in health economic evaluations: Correcting for compensation mechanisms and multiplier effects," Social Science & Medicine, Elsevier, vol. 75(11), pages 1981-1988.
    17. Bengt Liljas, 2010. "On the welfare theoretic foundation of cost-effectiveness analysis—the case when survival is not affected," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(1), pages 5-13, February.
    18. Marieke Krol & Arthur E. Attema & Job van Exel & Werner Brouwer, 2016. "Altruistic Preferences in Time Tradeoff," Medical Decision Making, , vol. 36(2), pages 187-198, February.
    19. Marieke Krol & Jocé Papenburg & Marc Koopmanschap & Werner Brouwer, 2011. "Do Productivity Costs Matter?," PharmacoEconomics, Springer, vol. 29(7), pages 601-619, July.
    20. P. Beutels & W. J. Edmunds & R. D. Smith, 2008. "Partially wrong? Partial equilibrium and the economic analysis of public health emergencies of international concern," Health Economics, John Wiley & Sons, Ltd., vol. 17(11), pages 1317-1322.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0012223. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.