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Health Policy Plan. 1999 Dec;14(4):301-12.

The evidence base on the cost-effectiveness of malaria control measures in Africa.

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  • 1Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK. c.goodman@lshtm.ac.uk

Abstract

This review assesses the range and quality of the evidence base on the cost-effectiveness of malaria prevention and treatment in sub-Saharan Africa. Fourteen studies are reviewed, covering insecticide-treated nets, residual spraying, chemoprophylaxis for children, chemoprophylaxis or intermittent treatment for pregnant women, a hypothetical vaccine, and changing the first line drug for treatment. The available evidence provides some guidance to decision-makers. However, the potential to inform policy debates is limited by the gross lack of information on the costs and effects of many interventions, the very small number of cost-effectiveness analyses available, the lack of evidence on the costs and effects of packages of measures, and the problems in generalizing or comparing studies that relate to specific settings and use different methodologies and outcome measures.

PIP:

This article reviews the range and quality of the evidence based on the cost-effectiveness of malaria prevention and treatment in sub-Saharan Africa. About 14 studies were analyzed, covering insecticide-treated nets, residual spraying, chemoprophylaxis for children, chemoprophylaxis or intermittent treatment for pregnant women, a hypothetical vaccine, and changing the first line drug for treatment. Results of the analyses demonstrate that highly cost-effective interventions exist for both prevention and treatment; that approaches to improving treatment are likely to be highly cost-effective; and that given the uncertainty and variation involved, the choice between childhood preventive interventions is not clear-cut due to the considerable overlap in their cost-effectiveness ranges. The review also cites several challenges in using cost-effectiveness estimates for policy-making. In conclusion, evidence from economic evaluations can assist policy-makers in identifying interventions representing the best value for money. Available studies provide some guidance to decision-makers. However, the current potential of economic evaluation to inform policy debates is limited by: the gross lack of information on the costs and effects of many interventions; the very small number of cost-effectiveness analyses available; the lack of evidence on the costs and effects of packages of measures; and the problems generalizing or comparing studies that relate to specific settings and use different methodologies and outcome measures.

PMID:
10787646
[PubMed - indexed for MEDLINE]
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