Tafenoquine following G6PD screening versus primaquine for the treatment of vivax malaria in Brazil: A cost-effectiveness analysis using a transmission model

David J Price, Narimane Nekkab, Wuelton M Monteiro, Daniel A M Villela, Julie A Simpson, Marcus V G Lacerda, Michael T White and Angela Devine

PLOS Medicine, 2024, vol. 21, issue 1, 1-17

Abstract: Background: Malaria transmission modelling has demonstrated the potential impact of semiquantitative glucose-6-phosphate dehydrogenase (G6PD) testing and treatment with single-dose tafenoquine for Plasmodium vivax radical cure but has not investigated the associated costs. This study evaluated the cost-effectiveness of P. vivax treatment with tafenoquine after G6PD testing using a transmission model. Methods and findings: We explored the cost-effectiveness of using tafenoquine after G6PD screening as compared to usual practice (7-day low-dose primaquine (0.5 mg/kg/day) without G6PD screening) in Brazil using a 10-year time horizon with 5% discounting considering 4 scenarios: (1) tafenoquine for adults only assuming 66.7% primaquine treatment adherence; (2) tafenoquine for adults and children aged >2 years assuming 66.7% primaquine adherence; (3) tafenoquine for adults only assuming 90% primaquine adherence; and (4) tafenoquine for adults only assuming 30% primaquine adherence. The incremental cost-effectiveness ratios (ICERs) were estimated by dividing the incremental costs by the disability-adjusted life years (DALYs) averted. These were compared to a willingness to pay (WTP) threshold of US$7,800 for Brazil, and one-way and probabilistic sensitivity analyses were performed. Conclusions: In our modelling study that incorporated impact on transmission, tafenoquine prescribed after a semiquantitative G6PD testing was highly likely to be cost-effective in Brazil. These results demonstrate the potential health and economic importance of ensuring safe and effective radical cure. Why was this study done?: What did the researchers find?: What do these findings mean?:

Date: 2024
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004255 (text/html)
https://journals.plos.org/plosmedicine/article/fil ... 04255&type=printable (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:plo:pmed00:1004255

DOI: 10.1371/journal.pmed.1004255

Access Statistics for this article

More articles in PLOS Medicine from Public Library of Science
Bibliographic data for series maintained by plosmedicine ().