title: Pharmacoeconomics of Antimalarials in Private-for-Profit (PFP) Drug-Outlets in Gulu and Kitgum Towns, Northern Uganda.
abstract: BACKGROUND
  Clinically-diagnosed malaria is the leading cause of morbidity and mortality in Uganda accounting for 25 to 40% of outpatients, 15 to 20% of all hospital admissions, and 9 to 14% of all hospital deaths. This situation was exacerbated by The Lord's Resistance Army (LRA) rebellion in northern Uganda which completely ran down the health care system. While malaria remains the number one killer disease in northern Uganda, antimalarials are lacking in the public health facilities. Consequently, Private-for-profit drug-outlets have come up to help bridge the gap. However, the cost-effectiveness and treatment outcome ratings of antimalarials are not clear. Objective: To assess the pharmacoeconomics of malaria treatment in Private-for-profit (PFP) drug-outlets in Gulu Municipality and Kitgum Town Council.
  
  
  METHODS
  This was a descriptive cross-sectional study sites were registered drug outlets. Study participants were drug-outlet owners, their employees, and malaria patients. We employed both purposive and random sampling methods to select the study participants. Data were collected using questionnaires and analysed using the SPSS computer package.
  
  
  RESULTS
  Up to91.1% of the respondents indicated that antimalarials are expensive. The prices varied from less than 5,000 to over 20,000 Ugandan shillings per dose(Exchange rate: 1$ = Ush 2,650).Fansidar and chloroquine were rated as being relatively cheap and ACTs expensive (Ush 11,000 to 15,000). Duration of treatment, frequency of administration, needles and syringes, raised the cost of some medicines. Most patients preferred cheap medicines (76.2%); those with low administration frequencies (77.5%); and those with short treatment duration (95%). Most patients (80.9%) buy antimalarials without testing, while 66.6% do not buy full doses.
  
  
  CONCLUSIONS
  The cost benefit analysis of the use of antimalarials is unfavourable. The unit price of the medicines, their irrational use and the lack of professionals in the outlets together add up to high overall costs and poor treatment outcomes.
authors.affiliation: Faculty of Business and Development Studies, Gulu University, P. O. Box 166 Gulu, Uganda.
authors.forename: Mshilla
authors.initials: M
authors.lastname: Maghanga
authors.affiliation: Department of Physiology, Faculty of Medicine, Gulu University, P. O. Box 166 Gulu, Uganda.
authors.forename: Obai
authors.initials: O
authors.lastname: Gerald
authors.affiliation: Department of Pharmacology, Faculty of Medicine, Gulu University, P. O. Box 166 Gulu, Uganda.
authors.forename: Musoke
authors.initials: M
authors.lastname: David
keywords: ACTs; malaria; northern Uganda; pharmacoeconomics; private-for-profit drug outlets