ArticleThe American journal of tropical medicine and hygiene2019
Modeling the Economic Impact of Substandard and Falsified Antimalarials in the Democratic Republic of the Congo.
Article in The American journal of tropical medicine and hygiene, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Health, Economic, and Social Impacts of Substandard and Falsified Medicines in Low- and Middle-Income Countries: A Systematic Review of Methodological Approaches.The American journal of tropical medicine and hygiene · 2023Pooled it
- Governing AI for Pharmacovigilance in Low-Income Countries: Systems Perspective.Journal of medical Internet research · 2026Article
- Assessing knowledge, attitudes, and practices and demand-side interventions for combating substandard and falsified medicines: a scoping review.Journal of pharmaceutical policy and practice · 2025Review
- Article
- Reliability and validity of an innovative high performing healthcare system assessment tool.BMC health services research · 2023Article
- Modeling the Health and Economic Impact of Substandard and Falsified Medicines: A Review of Existing Models and Approaches.The American journal of tropical medicine and hygiene · 2022Review
- Implementation of field detection devices for antimalarial quality screening in Lao PDR-A cost-effectiveness analysis.PLoS neglected tropical diseases · 2021Article
- Substandard and Falsified Medicines: Proposed Methods for Case Finding and Sentinel Surveillance.JMIR public health and surveillance · 2021Article
- Congenital Transmission of Apicomplexan Parasites: A Review.Frontiers in microbiology · 2021Review
- Quality assurance systems of pharmaceutical distributors in low-income and middle-income countries: weaknesses and ways forward.BMJ global health · 2020Article
- Post-Marketing Surveillance of Quality of Artemether Injection Marketed in Southwest Nigeria.The American journal of tropical medicine and hygiene · 2020Article
- Impact of substandard and falsified antimalarials in Zambia: application of the SAFARI model.BMC public health · 2020Article
- Tackling the blind spot of poor-quality medicines in Universal Health Coverage.Journal of pharmaceutical policy and practice · 2020Review
- Article
- Poor-quality antimalarials further health inequities in Uganda.Health policy and planning · 2019Article
- Unintended Consequences and Hidden Obstacles in Medicine Access in Sub-Saharan Africa.Frontiers in public health · 2019Article
- The economic impact of substandard and falsified antimalarial medications in Nigeria.PloS one · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
Substandard and falsified medicines pose significant risks to global health, including increased deaths, prolonged treatments, and growing drug resistance. Antimalarials are one of the most common medications to be of poor quality in low- and middle-income countries. We assessed the health and economic impact of substandard and falsified antimalarials for children less than 5 years of age in the Democratic Republic of the Congo, which has one of the world's highest malaria mortality rates. We developed an agent-based model to simulate patient care-seeking behavior and medicine supply chain processes to examine the impact of antimalarial quality in Kinshasa province and Katanga region. We simulated the impact of potential interventions to improve medicinal quality, reduce stockouts, or educate caregivers. We estimated that substandard and falsified antimalarials are responsible for $20.9 million (35% of $59.6 million; 95% CI: $20.7-$21.2 million) in malaria costs in Kinshasa province and $130 million (43% of $301 million; $129-$131 million) in malaria costs in the Katanga region annually. If drug resistance to artemisinin were to develop, total annual costs of malaria could increase by $17.9 million (30%; $17.7-$18.0 million) and $73 million (24%; $72.2-$72.8 million) in Kinshasa and Katanga, respectively. Replacing substandard and falsified antimalarials with good quality medicines had a larger impact than interventions that prevented stockouts or educated caregivers. The results highlight the importance of improving access to good quality antimalarials to reduce the burden of malaria and mitigate the development of antimalarial resistance.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.