title: Budget Impact Analysis of Using Dihydroartemisinin-Piperaquine to Treat Uncomplicated Malaria in Children in Tanzania.
abstract: OBJECTIVE
  Dihydroartemisinin-piperaquine (DhP) is a very cost effective anti-malarial drug. The aim of this study was to predict the budget impact of using DhP as a first- or second-line drug to treat uncomplicated malaria in children in Tanzania.
  
  
  METHODS
  A dynamic Markov decision model was developed based on clinical and epidemiological data to estimate annual cases of malaria in children aged under 5 years. The model was used to predict the budget impact of introducing DhP as the first- or second-line anti-malarial drug, from the perspective of the National Malaria Control Program in 2014; thus, only the cost of drugs and diagnostics were considered. Probabilistic sensitivity analysis was performed to explore overall uncertainties in input parameters.
  
  
  RESULTS
  The model predicts that the policy that uses artemether-lumefantrine (AL) and DhP as the first- and second-line drugs (AL + DhP), respectively, will save about $US64,423 per year, while achieving a 3% reduction in the number of malaria cases, compared with that of AL + quinine. However, the policy that uses DhP as the first-line drug (DhP + AL) will consume an additional $US780,180 per year, while achieving a further 5% reduction in the number of malaria cases, compared with that of AL + DhP.
  
  
  CONCLUSIONS
  The use of DhP as the second-line drug to treat uncomplicated malaria in children in Tanzania is slightly cost saving. However, the policy that uses DhP as the first-line drug is somewhat more expensive but with more health benefits.
authors.affiliation: Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. pax_amani@yahoo.com.|Muhimbili University of Health and Allied Sciences, P.O. Box 65001, 11103, Dar es Salaam, Tanzania. pax_amani@yahoo.com.
authors.forename: Amani Thomas
authors.initials: AT
authors.lastname: Mori
authors.affiliation: Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. ole.norheim@uib.no.|Centre for Intervention Science in Maternal and Child Health, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. ole.norheim@uib.no.
authors.forename: Ole Frithjof
authors.initials: OF
authors.lastname: Norheim
authors.affiliation: Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. bjarne.robberstad@uib.no.|Centre for Intervention Science in Maternal and Child Health, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. bjarne.robberstad@uib.no.
authors.forename: Bjarne
authors.initials: B
authors.lastname: Robberstad
mesh_terms: D000962:Antimalarials / Q000191:economics* / Q000627:therapeutic use; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000191:economics* / Q000627:therapeutic use*; D002675:Child, Preschool; D003362:Cost-Benefit Analysis / Q000191:economics*; D004338:Drug Combinations; D004359:Drug Therapy, Combination / Q000191:economics; D004983:Ethanolamines / Q000191:economics / Q000627:therapeutic use; D005449:Fluorenes / Q000191:economics / Q000627:therapeutic use; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008288:Malaria / Q000188:drug therapy* / Q000191:economics*; D008390:Markov Chains; D018803:Models, Economic; D011804:Quinolines / Q000191:economics* / Q000627:therapeutic use*; D013636:Tanzania; D010879:Piperazines
chemical_list: D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes; D011804:Quinolines; C039060:artenimol; C034759:piperaquine; D010879:Piperazines