Costing malaria interventions from pilots to elimination programmes

© 2020 The Author(s). Background: Malaria programmes in countries with low transmission levels require evidence to optimize deployment of current and new tools to reach elimination with limited resources. Recent pilots of elimination strategies in Ethiopia, Senegal, and Zambia produced evidence of t...

Full description

Saved in:
Bibliographic Details
Main Authors: Katya Galactionova, Mar Velarde, Kafula Silumbe, John Miller, Anthony McDonnell, Ricardo Aguas, Thomas A. Smith, Melissa A. Penny
Other Authors: Universitat Basel
Format: Article
Published: 2020
Subjects:
Online Access:https://repository.li.mahidol.ac.th/handle/123456789/59112
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Mahidol University
id th-mahidol.59112
record_format dspace
spelling th-mahidol.591122020-10-05T12:40:56Z Costing malaria interventions from pilots to elimination programmes Katya Galactionova Mar Velarde Kafula Silumbe John Miller Anthony McDonnell Ricardo Aguas Thomas A. Smith Melissa A. Penny Universitat Basel Swiss Tropical and Public Health Institute (Swiss TPH) Mahidol University Nuffield Department of Medicine PATH Malaria Control and Elimination Partnership in Africa (MACEPA) Immunology and Microbiology Medicine © 2020 The Author(s). Background: Malaria programmes in countries with low transmission levels require evidence to optimize deployment of current and new tools to reach elimination with limited resources. Recent pilots of elimination strategies in Ethiopia, Senegal, and Zambia produced evidence of their epidemiological impacts and costs. There is a need to generalize these findings to different epidemiological and health systems contexts. Methods: Drawing on experience of implementing partners, operational documents and costing studies from these pilots, reference scenarios were defined for rapid reporting (RR), reactive case detection (RACD), mass drug administration (MDA), and in-door residual spraying (IRS). These generalized interventions from their trial implementation to one typical of programmatic delivery. In doing so, resource use due to interventions was isolated from research activities and was related to the pilot setting. Costing models developed around this reference implementation, standardized the scope of resources costed, the valuation of resource use, and the setting in which interventions were evaluated. Sensitivity analyses were used to inform generalizability of the estimates and model assumptions. Results: Populated with local prices and resource use from the pilots, the models yielded an average annual economic cost per capita of $0.18 for RR, $0.75 for RACD, $4.28 for MDA (two rounds), and $1.79 for IRS (one round, 50% households). Intervention design and resource use at service delivery were key drivers of variation in costs of RR, MDA, and RACD. Scale was the most important parameter for IRS. Overall price level was a minor contributor, except for MDA where drugs accounted for 70% of the cost. The analyses showed that at implementation scales comparable to health facility catchment area, systematic correlations between model inputs characterizing implementation and setting produce large gradients in costs. Conclusions: Prospective costing models are powerful tools to explore resource and cost implications of policy alternatives. By formalizing translation of operational data into an estimate of intervention cost, these models provide the methodological infrastructure to strengthen capacity gap for economic evaluation in endemic countries. The value of this approach for decision-making is enhanced when primary cost data collection is designed to enable analysis of the efficiency of operational inputs in relation to features of the trial or the setting, thus facilitating transferability. 2020-10-05T05:14:09Z 2020-10-05T05:14:09Z 2020-09-14 Article Malaria Journal. Vol.19, No.1 (2020) 10.1186/s12936-020-03405-3 14752875 2-s2.0-85091055086 https://repository.li.mahidol.ac.th/handle/123456789/59112 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85091055086&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Immunology and Microbiology
Medicine
spellingShingle Immunology and Microbiology
Medicine
Katya Galactionova
Mar Velarde
Kafula Silumbe
John Miller
Anthony McDonnell
Ricardo Aguas
Thomas A. Smith
Melissa A. Penny
Costing malaria interventions from pilots to elimination programmes
description © 2020 The Author(s). Background: Malaria programmes in countries with low transmission levels require evidence to optimize deployment of current and new tools to reach elimination with limited resources. Recent pilots of elimination strategies in Ethiopia, Senegal, and Zambia produced evidence of their epidemiological impacts and costs. There is a need to generalize these findings to different epidemiological and health systems contexts. Methods: Drawing on experience of implementing partners, operational documents and costing studies from these pilots, reference scenarios were defined for rapid reporting (RR), reactive case detection (RACD), mass drug administration (MDA), and in-door residual spraying (IRS). These generalized interventions from their trial implementation to one typical of programmatic delivery. In doing so, resource use due to interventions was isolated from research activities and was related to the pilot setting. Costing models developed around this reference implementation, standardized the scope of resources costed, the valuation of resource use, and the setting in which interventions were evaluated. Sensitivity analyses were used to inform generalizability of the estimates and model assumptions. Results: Populated with local prices and resource use from the pilots, the models yielded an average annual economic cost per capita of $0.18 for RR, $0.75 for RACD, $4.28 for MDA (two rounds), and $1.79 for IRS (one round, 50% households). Intervention design and resource use at service delivery were key drivers of variation in costs of RR, MDA, and RACD. Scale was the most important parameter for IRS. Overall price level was a minor contributor, except for MDA where drugs accounted for 70% of the cost. The analyses showed that at implementation scales comparable to health facility catchment area, systematic correlations between model inputs characterizing implementation and setting produce large gradients in costs. Conclusions: Prospective costing models are powerful tools to explore resource and cost implications of policy alternatives. By formalizing translation of operational data into an estimate of intervention cost, these models provide the methodological infrastructure to strengthen capacity gap for economic evaluation in endemic countries. The value of this approach for decision-making is enhanced when primary cost data collection is designed to enable analysis of the efficiency of operational inputs in relation to features of the trial or the setting, thus facilitating transferability.
author2 Universitat Basel
author_facet Universitat Basel
Katya Galactionova
Mar Velarde
Kafula Silumbe
John Miller
Anthony McDonnell
Ricardo Aguas
Thomas A. Smith
Melissa A. Penny
format Article
author Katya Galactionova
Mar Velarde
Kafula Silumbe
John Miller
Anthony McDonnell
Ricardo Aguas
Thomas A. Smith
Melissa A. Penny
author_sort Katya Galactionova
title Costing malaria interventions from pilots to elimination programmes
title_short Costing malaria interventions from pilots to elimination programmes
title_full Costing malaria interventions from pilots to elimination programmes
title_fullStr Costing malaria interventions from pilots to elimination programmes
title_full_unstemmed Costing malaria interventions from pilots to elimination programmes
title_sort costing malaria interventions from pilots to elimination programmes
publishDate 2020
url https://repository.li.mahidol.ac.th/handle/123456789/59112
_version_ 1763497104592863232