Cost-Benefit Analysis

Publication Title: 
Harefuah

This article assesses the evidence for effectiveness, adverse effects and cost-effectiveness of complementary therapies, as reflected in publications in high impact factor medical journals during the years 2012-2014. The search detected 13 randomized controlled studies (RCTs) and 14 meta-analyses, which collectively assessed results of 191 RCTs involving the participation of several thousand patients. Pain was the major focus of acupuncture research in both clinical and fMRI studies, which demonstrated that the effect of acupuncture is beyond the placebo effect.

Author(s): 
Gamus, Dorit
Publication Title: 
Bulletin of the World Health Organization

A randomized, controlled, malaria-clinic-based field trial was carried out to compare the cost-effectiveness of a 5-day 700-mg oral artesunate and a 7-day quinine + tetracycline regimen for the treatment of uncomplicated falciparum malaria in Thailand. Cost-effectiveness was determined from the providers' perspective and based on curative effectiveness. A total of 137 patients, aged 15-60 years, attending a malaria clinic were followed for 28 days, 60 of them received quinine + tetracycline and 77 received artesunate.

Author(s): 
Honrado, E. R.
Fungladda, W.
Kamoiratanaku, P.
Kitayaporn, D.
Karbwang, J.
Thimasarn, K.
Masngammueng, R.
Publication Title: 
Tropical medicine & international health: TM & IH

As part of a study to assess the infectivity of gametocytes after treatment with four antimalarial regimens, the efficacy of each treatment was also determined. From September to December 1998, 598 children with uncomplicated malaria were treated; 135 received chloroquine (CQ) alone, 276 received pyrimethamine/sulfadoxine (Fansidar, PSD) alone, 113 received PSD with a single dose of artesunate (PSD + 1ART) and 74 received PSD combined with three doses of artesunate (PSD + 3ART). On day 28 19/63 (30.2%; 95% C.I. 19.2% to 43.1%) of children treated with CQ alone, 5/134 (3.7%; 95% C.I.

Author(s): 
von Seidlein, L.
Jawara, M.
Coleman, R.
Doherty, T.
Walraven, G.
Targett, G.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

Artemisinin-based combination therapies (ACTs) are generally regarded as vital in addressing the growing problem posed by the development of antimalarial resistance across sub-Saharan Africa. However, the costs of the new ACTs are likely to be significantly higher than current therapies. Therefore, it is important to examine formally the cost-effectiveness of the more effective yet more expensive ACTs before advocating a switch in policy.

Author(s): 
Coleman, Paul G.
Morel, Chantal
Shillcutt, Sam
Goodman, Catherine
Mills, Anne J.
Publication Title: 
BMJ (Clinical research ed.)

OBJECTIVE: To determine the cost effectiveness of selected malaria control interventions in the context of reaching the millennium development goals for malaria. DESIGN: Generalised cost effectiveness analysis. DATA SOURCES: Efficacy data came from the literature and authors' calculations supported by expert opinion. Quantities for resource inputs came from the literature and from expert opinion; prices came from the WHO-CHOICE database.

Author(s): 
Morel, Chantal M.
Lauer, Jeremy A.
Evans, David B.
Publication Title: 
Tropical medicine & international health: TM & IH

OBJECTIVE: To compare the cost-effectiveness of malaria treatment based on presumptive diagnosis with that of malaria treatment based on rapid diagnostic tests (RDTs). METHODS: We calculated direct costs (based on experience from Ethiopia and southern Sudan) and effectiveness (in terms of reduced over-treatment) of a free, decentralised treatment programme using artesunate plus amodiaquine (AS + AQ) or artemether-lumefantrine (ART-LUM) in a Plasmodium falciparum epidemic. Our main cost-effectiveness measure was the incremental cost per false positive treatment averted by RDTs.

Author(s): 
Rolland, Estelle
Checchi, Francesco
Pinoges, Loretxu
Balkan, Suna
Guthmann, Jean-Paul
Guerin, Philippe J.
Publication Title: 
PLoS medicine

BACKGROUND: As a result of rising levels of drug resistance to conventional monotherapy, the World Health Organization (WHO) and other international organisations have recommended that malaria endemic countries move to combination therapy, ideally with artemisinin-based combinations (ACTs). Cost is a major barrier to deployment. There is little evidence from field trials on the cost-effectiveness of these new combinations.

Author(s): 
Wiseman, Virginia
Kim, Michelle
Mutabingwa, Theonest K.
Whitty, Christopher J. M.
Publication Title: 
Malaria Journal

BACKGROUND: Malaria remains a leading cause of morbidity, mortality and non-fatal disability in Zambia, especially among children, pregnant women and the poor. Data gathered by the National Malaria Control Centre has shown that recently observed widespread treatment failure of SP and chloroquine precipitated a surge in malaria-related morbidity and mortality. As a result, the Government has recently replaced chloroquine and SP with combination therapy as first-line treatment for malaria.

Author(s): 
Chanda, Pascalina
Masiye, Felix
Chitah, Bona M.
Sipilanyambe, Naawa
Hawela, Moonga
Banda, Patrick
Okorosobo, Tuoyo
Publication Title: 
Malaria Journal

BACKGROUND: Rapid diagnostic tests (RDTs) for malaria are increasingly being considered for routine use in Africa. However, many RDTs are available and selecting the ideal test for a particular setting is challenging. The appropriateness of RDT choice depends in part on patient population and epidemiological setting, and on decision makers' priorities. The model presented (available online) can be used by decision makers to evaluate alternative RDTs and assess the circumstances under which their use is justified on economic grounds.

Author(s): 
Lubell, Yoel
Hopkins, Heidi
Whitty, Christopher J. M.
Staedke, Sarah G.
Mills, Anne
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

The introduction of artemisinin-based combination therapy in sub-Saharan Africa has prompted calls for increased use of parasitologic diagnosis for malaria. We evaluated the cost-effectiveness of rapid diagnostic tests (RDTs) in comparison to microscopy in guiding treatment of non-severe febrile illness at varying levels of malaria endemicity using data on test accuracy and costs collected as part of a Tanzanian trial.

Author(s): 
Lubell, Yoel
Reyburn, Hugh
Mbakilwa, Hilda
Mwangi, Rose
Chonya, Kini
Whitty, Christopher J. M.
Mills, Anne

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