PharmacoEconomics & Outcomes News 784, p9 - 12 Aug 2017 Antimalarial therapy by community workers cost effective Pre-referral antimalarial treatment in children provided by community healthcare workers (CHWs) appears to be cost effective in Kenya, according to findings of a cost-utility analysis published in Cost Effectiveness and Resource Allocation. A decision analytical model was used to evaluate the cost effectiveness of pre-referral antimalarial treatment with rectal artesunate provided by CHWs or by primary healthcare workers, or direct access to treatment at a tertiary healthcare facility or no intervention, in a hypothetical cohort of 1000 children in rural areas of Kenya with high malaria endemicity. Cost effectiveness was evaluated from the perspective of the Government of Kenya over a 5-year time horizon (from birth to 5 years of age). Based on disability weights obtained from WHO data for the sub-Saharan region, assumed disability weights were 0.211 for a malaria episode, 0.471 for neurological sequelae and 0.013 for anaemia. Compared with no intervention in 1000 patients, rectal pre-referral treatment provided by CHWs was estimated to avert 15 535 disability-adjusted life-years (DALYs) an incremental cost of $85 490, while similar treatment by primary healthcare workers was estimated to avert 12 610 DALYs at an incremental cost of $88 960, and treatment at a tertiary healthcare facility was estimated to avert 17 936 DALYs at an incremental cost of $123 710. The estimated incremental cost-effectiveness ratio (ICER) for pre-referral treatment by CHWs versus no intervention was $5.50 per DALY averted, the ICER for pre-referral treatment by primary healthcare workers was $7.05 per DALY averted, and the ICER for tertiary healthcare treatment was $6.90 per DALY averted. "This study recommends the strengthening of community strategy in regards to uptake and referral compliance," said the authors. "The results from this study can be used to persuade policy makers to provide rectal artesunate as a pre-referral intervention in rural hard to reach areas," they added. * 2015 international dollars Rakuomi V, et al. Cost effectiveness of pre-referral antimalarial treatment in severe malaria among children in sub-Saharan Africa. Cost Effectiveness and Resource Allocation : 14 Jul 2017. Available from: URL: https://doi.org/10.1186/ s12962-017-0076-5 803261752 1173-5503/17/0784-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 12 Aug 2017 No. 784
PharmacoEconomics & Outcomes News – Springer Journals
Published: Aug 12, 2017
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