Budget impact analysis of using dihydroartemisinin–piperaquine to treat uncomplicated malaria in children in Tanzania

Abstract

Background and Objective: Dihydroartemisinin–piperaquine (DhP) is a very cost effective anti-malarial drug. The aim of this study was to predict the budget impact of using DhP as a first- or second-line drug to treat uncomplicated malaria in children in Tanzania. Methods: A dynamic Markov decision model was developed based on clinical and epidemiological data to estimate annual cases of malaria in children aged under 5 years. The model was used to predict the budget impact of introducing DhP as the first- or second-line anti-malarial drug, from the perspective of the National Malaria Control Program in 2014; thus, only the cost of drugs and diagnostics were considered. Probabilistic sensitivity analysis was performed to explore overall uncertainties in input parameters. Results: The model predicts that the policy that uses artemether–lumefantrine (AL) and DhP as the first- and second-line drugs (AL + DhP), respectively, will save about US64,423 per year, while achieving a 3 % reduction in the number of malaria cases, compared with that of AL + quinine. However, the policy that uses DhP as the first-line drug (DhP + AL) will consume an additional $US780,180 per year, while achieving a further 5 % reduction in the number of malaria cases, compared with that of AL + DhP. Conclusion: The use of DhP as the second-line drug to treat uncomplicated malaria in children in Tanzania is slightly cost saving. However, the policy that uses DhP as the first-line drug is somewhat more expensive but with more health benefits.