Market for Artemether‐Lumefantrine to treat childhood malaria in a district of southern Mozambique

Abstract

Malaria is one of the leading causes of death in sub-Saharan Africa. Artemisinin-based combination therapies are used as first-line treatment drugs, but their market is far from competitive. Market failures include limited availability, low quality, lack of information, and high costs of access. We estimated the theoretical demand for one of the most common artemisinin-based combination therapies, artemether-lumefantrine (AL), and its determinants among caregivers of children with malaria seeking care at public health facilities, thus, entitled to receive drugs for free, in southern Mozambique (year 2012). The predicted theoretical demand was contrasted with international and local private market AL prices. Respondents stated high willingness to pay but lower ability to pay (ATP), which was defined as the theoretical demand. The ATP was on average of 0.94 USD for the treatment of a malaria episode. This implied an average gap of 1.04 USD between average local private prices and theoretical demand. Predicted ATP decreased by 14% for every additional malaria episode that the child had suffered during the malaria season. The market price was unaffordable for a large share of our sample, highlighting an unequal welfare distribution between suppliers and potential consumers, as well as issues of inequity in the private delivery of AL.

The economic burden of malaria on households and the health system in a high transmission district of Mozambique

“…In accordance with the national guidelines microscopy was assumed to be used to check for parasitological density each day during the admission. Malaria treatment was computed as the price per dose according to patient’s age, used as a proxy for weight [27–29]. A three-day course artemether–lumefantrine (AL) was assumed to follow parenteral therapy with artesunate [28].…”