Oral Presentation First Malaria World Congress 2018

Global economic costs due to P. vivax malaria treatment and the cost-benefit of radical cure (#34)

Angela Devine 1 2 , Katherine E Battle 3 , Rosalind E Howes 3 4 , Ric N Price 2 5 , Yoel Lubell 1 5
  1. Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
  2. Global and Tropical Health Division, Menzies, Tiwi, NT, Australia
  3. Oxford Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
  4. Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA
  5. Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK

Aims: To estimate the current global economic cost of illness to healthcare providers and patient households and to explore the potential cost-benefit of implementing radical cure following a normal G6PD test result.

Methods:  Estimates of the cost of vivax malaria treatment for healthcare providers and patient households were collated from a literature review and primary costing studies, and combined with case estimates generated by the Malaria Atlas Project. A cost-benefit analysis of implementing effective global radical cure compared the cost of G6PD screening and supervised radical cure with the cost savings from the prevention of relapses. It was assumed that when adhered to, the 14-day primaquine regimen was 85% effective and required 3.5 healthcare worker days to supervise daily therapy (valued at one gross domestic product per capita per day).

Results: The estimate of the global cost of P. vivax was US$330 million (range US$205-459 million). Adopting a policy of screening for G6PD deficiency and delivery of highly effective radical cure was projected to save US$45 million per year from the societal perspective. Household costs decreased by US$124 million; however, provider costs increased by US$80 million attributable primarily to the inclusion of supervised primaquine therapy.

Conclusions: The global societal costs of vivax malaria are substantial, but can be reduced through the use of effective radical cure following screening for G6PD deficiency. Novel, less costly interventions for ensuring adherence to primaquine regimens for effective radical cure are needed to reduce healthcare provider costs and provide a pathway to malaria elimination.