Cost–effectiveness of artemisinin combination therapy for uncomplicated malaria in children: data from Papua New Guinea
Wendy A Davis, Philip M Clarke, Peter M Siba, Harin A Karunajeewa, Carol Davy, Ivo Mueller & Timothy ME Davis
Volume 89, Number 3, March 2011, 211-220
Table 1. Main unit costs associated with participation in randomized four-arm trial in children aged 6–60 months with uncomplicated malaria, Papua New Guinea, 2007–2008
|Cost item||Unit cost
|Health clinic visit|
|Outpatient||0.517||Alexishafen Health Clinic, Madang||Per treatment course paid for at first visit|
|Inpatient||3.44||Alexishafen Health Clinic, Madang||One-off admission fee regardless of no. of nights|
|Transport to health clinica||1.72||Alexishafen Health Clinic, Madang||5 (usual) to 20 (far) PGKb round trip|
|CQ, 150 mg||0.010||MTEFc 2006–07 prices||–|
|S+P: 500 mg of S, 25 mg of P||0.013||MTEF 2006–07 prices||–|
|ARTS, 50 mg||0.184||MTEF 2006–07 prices||–|
|DHA+PQ: 40 mg of DHA, 320 mg of PQ||0.137||Beijing Holley Cotec, China||US$ 0.125 per tablet|
|A+L: 20 mg of A, 120 mg of L||0.0617||Novartis Pharma AG price to WHO, 2008||–|
|Quinine sulfate tablets, 300 mg||0.022||MTEF 2006–07 prices||–|
|Quinine dihydrochloride, 300 mg/ml, 2 ml||0.241||MTEF 2006–07 prices||–|
|Tests and other medications||–|
|Hb finger prick test||0.107||MTEF 2006–07 prices||On days 0–42 and sick days|
|Paracetamol syrup, 120 mg/5 ml||0.00057/ml||MTEF 2006–07 prices||15 mg/kg, if axillary temperature ≥ 37.5 °C|
|Albendazole, 200 mg tablet||0.007`||MTEF 2006–07 prices||For hookworm, on day 42 if Hb < 10 g/dl|
|FeSO4, 200 mg; folic acid, 500 μg||0.001||MTEF 2006–07 prices||On day 42 if Hb < 10 g/dl|
|Amodiaquine, 100 mg tablet||0.005||MTEF 2006–07 prices||On day 42 if Hb < 10 g/dl and splenomegaly ≥ grade 3d|
|Milk, 250 ml tetra packs full cream (32.15 PGK per 24 packs)||0.462||Wholesale, 2008||–|
|Malaria microscopy||0.710||MTEF 2006–07 prices||–|
|Syringe, disposable 10 ml, 21-gauge needle||0.046||MTEF 2006–07 prices||–|
|Gloves, disposable||0.004 a pair||MTEF 2006–07 prices||–|
|Blood lancet, disposable||0.043||MTEF 2006–07 prices||–|
|Alcohol wipe, 1 per blood sample (9.30 PGK per box of 200 sealed wipes)||0.016||Retail pharmacy, 2008||–|
|Cotton wool swab, 1 per blood sample||0.007||MTEF 2006–07 prices||–|
A, artemether; ARTS, artesunate; CQ, chloroquine; DHA, dihydroartemisinin; FeSO4, ferrous sulfate; ; Hb, haemoglobin; L, lumefantrine; MTEF: Medium-Term Expenditure Framework; P, pyrimethamine; PGK, Papua New Guinea kina; PQ, piperaquine; S, sulfadoxine; US$, United States dollars; WHO, World Health Organization.
a Based on cost of travel, by public transport, for the average distance to the clinic in the surrounding area.
b One PGK is equivalent to US$ 0.345 (2007–08).
c Framework of the Papua New Guinea National Department of Health.
d Hackett grade 3: spleen palpable between Grade 2 limit (halfway between left costal margin and level of umbilicus) and level of umbilicus.
e Inpatients and their families need to provide their own food and cooking facilities. Patients who are very sick go to hospital; others visit the local health clinic. In this study no child was referred to hospital.