Evidence map›Paper›PMID 29084540›Full record

ArticleMalaria journal2017

Cost-effectiveness of artemisinin-naphthoquine versus artemether-lumefantrine for the treatment of uncomplicated malaria in Papua New Guinean children.

Brioni R Moore, Wendy A Davis, Philip M Clarke, Leanne J Robinson, Moses Laman, Timothy M E Davis

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Malaria journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 80% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Costs and Cost-Effectiveness of Malaria Control Interventions: A Systematic Literature Review.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2021
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Brioni R MooreSchool of Pharmacy, Curtin University of Technology, Perth, WA, Australia.
Wendy A DavisSchool of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
Philip M ClarkeMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Leanne J RobinsonPapua New Guinea Institute of Medical Research, Madang, Papua New Guinea.
Moses LamanPapua New Guinea Institute of Medical Research, Madang, Papua New Guinea.
Timothy M E DavisSchool of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia. tim.davis@uwa.edu.au.ORCID 0000-0003-0749-7411
The University of Western Australia · AUBurnet Institute · AUPapua New Guinea Institute of Medical Research · PGThe University of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA recent randomized trial showed that artemisinin-naphthoquine (AN) was non-inferior to artemether-lumefantrine (AL) for falciparum malaria and superior for vivax malaria in young Papua New Guinean children. The aim of this study was to compare the cost-effectiveness of these two regimens.

methodsAn incremental cost-effectiveness analysis was performed using data from 231 children with Plasmodium falciparum and/or Plasmodium vivax infections in an open-label, randomized, parallel-group trial. Recruited children were randomized 1:1 to receive once daily AN for 3 days with water or twice daily AL for 3 days given with fat. World Health Organisation (WHO) definitions were used to determine clinical/parasitological outcomes. The cost of transport between the home and clinic, plus direct health-care costs, served as a basis for determining each regimen's incremental cost per incremental treatment success relative to AL by Day 42 and its cost per life year saved.

resultsIn the usual care setting, AN was more effective for the treatment of uncomplicated malaria in children aged 0.5-5.9 years. AL and AN were equally efficacious for the treatment of falciparum malaria, however AN had increased anti-malarial treatment costs per patient of $10.46, compared with AL. AN was the most effective regimen for treatment of vivax malaria, but had increased treatment costs of $14.83 per treatment success compared with AL.

conclusionsWhilst AN has superior overall efficacy for the treatment of uncomplicated malaria in PNG children, AL was the less costly regimen. An indicative extrapolation estimated the cost per life year saved by using AN instead of AL to treat uncomplicated malaria to be $12,165 for girls and $12,469 for boys (discounted), which means AN may not be cost-effective and affordable for PNG at current cost. However, AN may become acceptable should it become WHO prequalified and/or should donated/subsidized drug supply become available.

Indexed as

Cost-Benefit AnalysisAntimalarialsArtemether, Lumefantrine Drug CombinationArtemisininsChild, PreschoolDrug CombinationsEthanolaminesFemaleFluorenesHumansInfantMalaria, FalciparumMalaria, VivaxMaleNaphthoquinonesPapua New GuineaAntimalarialsArtemether, Lumefantrine Drug Combinationartemisinin-naphthoquine combinationArtemisininsDrug CombinationsEthanolaminesFluorenesNaphthoquinonesArtemether–lumefantrineArtemisinin–naphthoquineChildrenCost-effectivenessUncomplicated malaria

Identifiers

PMID29084540
PMCPMC5663042
OpenAlexW2766560284

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.