Gogtay N J, Kadam V S, Desai S, Kamtekar K D, Dalvi S S, Kshirsagar N A
Department of Clinical Pharmacology, 100 Bedded Building, 4th Floor, TN Medical College and BYL Nair Ch. Hospital, Dr AL Nair Road, Mumbai Central, Mumbai-400 008, India.
J Assoc Physicians India. 2003 Sep;51:877-9.
Malaria is a major public health problem representing 2.3% of the overall global disease burden. The cost of treatment of malaria continues to rise as older drugs and insecticides become less effective and are replaced by more effective, but also more expensive products.
A post-hoc pharmacoeconomic analysis (direct and indirect costs only) of three antimalarials, chloroquine, mefloquine and co-artemether, was carried out to address the problem of switch to a more expensive first-line antimalarial in the face of growing chloroquine resistance.
From the perspective of a large public hospital, it was seen that in an area of high grade chloroquine resistance, the total expenditure on patients who fail chloroquine would exceed the excess expenditure on mefloquine when the RII + RIII resistance exceeded 9%.
Switch to a more expensive drug like mefloquine as a first-line option would be cost-effective when the moderate-severe chloroquine resistance exceeded 9%.
疟疾是一个重大的公共卫生问题，占全球疾病总负担的2.3%。随着旧药物和杀虫剂效果降低，并被更有效但也更昂贵的产品所取代，疟疾治疗成本持续上升。
进行了一项事后药物经济学分析（仅直接和间接成本），涉及三种抗疟药，氯喹、甲氟喹和复方蒿甲醚，以解决面对氯喹耐药性增加而改用更昂贵的一线抗疟药的问题。
从一家大型公立医院的角度来看，发现在氯喹高耐药地区，当RII + RIII耐药性超过9%时，氯喹治疗失败患者的总支出将超过甲氟喹的额外支出。
当中重度氯喹耐药性超过9%时，改用更昂贵的药物如甲氟喹作为一线选择具有成本效益。
