Publication: Cost of treating inpatient falciparum malaria on the Thai-Myanmar border
Issued Date
2014
Resource Type
Language
eng
Rights
Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
Malaria Journal. Vol.13, (2014), 416
Suggested Citation
Kyaw, Shwe Sin, Tom Drake, Ronatrai Ruangveerayuth, Wirongrong Chierakul, White, Nicholas J, Newton, Paul N, Yoel Lubell Cost of treating inpatient falciparum malaria on the Thai-Myanmar border. Malaria Journal. Vol.13, (2014), 416. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/3072
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Thesis
Title
Cost of treating inpatient falciparum malaria on the Thai-Myanmar border
Abstract
Background: Despite demonstrated benefits and World Health Organization (WHO) endorsement, parenteral
artesunate is the recommended treatment for patients with severe Plasmodium falciparum malaria in only one fifth
of endemic countries. One possible reason for this slow uptake is that a treatment course of parenteral artesunate is
costlier than quinine and might, therefore, pose a substantial economic burden to health care systems. This analysis
presents a detailed account of the resources used in treating falciparum malaria by either parenteral artesunate or
quinine in a hospital on the Thai-Myanmar border.
Methods: The analysis used data from four studies, with random allocation of inpatients with falciparum malaria to
treatment with parenteral artesunate or quinine, conducted in Mae Sot Hospital, Thailand from 1995 to 2001.
Detailed resource use data were collected during admission and unit costs from the 2008 hospital price list were
applied to these. Total admission costs were broken down into five categories: 1) medication; 2) intravenous fluids;
3) disposables; 4) laboratory tests; and 5) services.
Results: While the medication costs were higher for patients treated with artesunate, total admission costs were
similar in those treated with quinine, US$ 243 (95% CI: 167.5-349.7) and in those treated with artesunate US$ 190
(95% CI: 131.0-263.2) (P = 0.375). For cases classified as severe malaria (59%), the total cost of admission was US$ 298
(95% CI: 203.6-438.7) in the quinine group as compared with US$ 284 (95% CI: 181.3-407) in the artesunate group
(P = 0.869).
Conclusion: This analysis finds no evidence for a difference in total admission costs for malaria inpatients treated
with artesunate as compared with quinine. Assuming this is generalizable to other settings, the higher cost of a
course of artesunate should not be considered a barrier for its implementation in the treatment of malaria.
