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Cost-effectiveness analysis of malaria rapid diagnostic test incentive schemes for informal private healthcare providers in Myanmar

Overview of attention for article published in Malaria Journal, February 2015
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Title
Cost-effectiveness analysis of malaria rapid diagnostic test incentive schemes for informal private healthcare providers in Myanmar
Published in
Malaria Journal, February 2015
DOI 10.1186/s12936-015-0569-7
Pubmed ID
Authors

Ingrid T Chen, Tin Aung, Hnin Nwe Nwe Thant, May Sudhinaraset, James G Kahn

Abstract

BackgroundThe emergence of artemisinin-resistant Plasmodium falciparum parasites in Southeast Asia threatens global malaria control efforts. One strategy to counter this problem is a subsidy of malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) within the informal private sector, where the majority of malaria care in Myanmar is provided. A study in Myanmar evaluated the effectiveness of financial incentives vs information, education and counselling (IEC) in driving the proper use of subsidized malaria RDTs among informal private providers. This cost-effectiveness analysis compares intervention options.MethodsA decision tree was constructed in a spreadsheet to estimate the incremental cost-effectiveness ratios (ICERs) among four strategies: no intervention, simple subsidy, subsidy with financial incentives, and subsidy with IEC. Model inputs included programmatic costs (in dollars), malaria epidemiology and observed study outcomes. Data sources included expenditure records, study data and scientific literature. Model outcomes included the proportion of properly and improperly treated individuals with and without P. falciparum malaria, and associated disability-adjusted life years (DALYs). Results are reported as ICERs in US dollars per DALY averted. One-way sensitivity analysis assessed how outcomes depend on uncertainty in inputs.ResultsICERs from the least to most expensive intervention are: $1,169/DALY averted for simple subsidy vs no intervention, $185/DALY averted for subsidy with financial incentives vs simple subsidy, and $200/DALY averted for a subsidy with IEC vs subsidy with financial incentives. Due to decreasing ICERs, each strategy was also compared to no intervention. The subsidy with IEC was the most favourable, costing $639/DALY averted compared with no intervention. One-way sensitivity analysis shows that ICERs are most affected by programme costs, RDT uptake, treatment-seeking behaviour, and the prevalence and virulence of non-malarial fevers. In conclusion, private provider subsidies with IEC or a combination of IEC and financial incentives may be a good investment for malaria control.

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Mendeley readers

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The data shown below were compiled from readership statistics for 95 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Nigeria 1 1%
Unknown 93 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 21 22%
Researcher 10 11%
Student > Postgraduate 8 8%
Lecturer 5 5%
Student > Bachelor 5 5%
Other 18 19%
Unknown 28 29%
Readers by discipline Count As %
Medicine and Dentistry 32 34%
Social Sciences 7 7%
Economics, Econometrics and Finance 6 6%
Nursing and Health Professions 5 5%
Agricultural and Biological Sciences 3 3%
Other 12 13%
Unknown 30 32%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 February 2015.
All research outputs
#21,868,379
of 24,400,706 outputs
Outputs from Malaria Journal
#5,592
of 5,827 outputs
Outputs of similar age
#308,060
of 361,036 outputs
Outputs of similar age from Malaria Journal
#84
of 102 outputs
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