The Investment Case for Malaria Elimination in Thailand: A Cost–Benefit Analysis

Abstract

After a dramatic decline in the annual malaria incidence in Thailand since 2000, the Thai government developed a National Malaria Elimination Strategy (NMES) to end local malaria transmission by 2024. This study examines the expected costs and benefits of funding the NMES (elimination scenario) versus not funding malaria elimination programming (resurgence scenario) from 2017 to 2036. Two case projection approaches were used to measure the number of malaria cases over the study period, combined with a set of Thailand-specific economic assumptions, to evaluate the cost of a malaria case and to quantify the cost-benefit ratio of elimination. Model A projects cases based on national historical case data using a log-normal regression and change-point analysis model. Model B projects cases based on periodic Yala Province-level outbreak cycles and incorporating NMES political and programmatic goals. In the base case, both models predict that elimination would prevent 1.86-3.11 million malaria cases from 2017 to 2036, with full NMES implementation proving to be cost-saving in all models, perspectives, and scenarios, except for the health system-only perspective in the Model A base case and all perspectives in the Model A worst case. From the societal perspective, every 1 US dollars (US$) spent on the NMES would-depending on case projections used-potentially result in a considerable return on investment, ranging from US$ 2 to US$ 15. Although the two case projection approaches resulted in different cost-benefit ratios, both models showed cost savings and suggest that ending local malaria transmission in Thailand would yield a positive return on investment.

Cost-benefit analysis of malaria elimination phase surveillance measures in Fujian Province

“…When the BCR is less than one and the NB is negative, the cost of the measure is higher than its efficiency. In other words, the implementation of this measure is economically burdensome, and the strategy should be adjusted (12,13).…”

Cost-benefit analysis of the monitoring measures for the malaria elimination stage in Fujian, China

“…When the BCR is less than one and the NB is negative, the cost of the measure is higher than its e ciency. In other words, the implementation of this measure is economically burdensome, and the strategy should be adjusted (12,13).…”

Monitoring Measures in the Elimination of Malaria in Fujian, China: A Cost-Benefit Analysis

“…We reviewed the literature on the economic evaluation of malaria [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23], held discussions with the research team, consulted the experts on malaria, and then determined the typical bene t indicators. The economic bene ts included the direct medical and non-medical bene ts of avoiding hospitalization and missed work bene ts of avoiding hospitalization.…”

“…The If BCR > 1 and NB is positive, the monitoring measures were bene cial to the economy. If BCR < 1 and the NB is negative, the monitoring measure cost was higher than the bene t, which means the implementation of those measures was economically burdensome at the malaria elimination stage and the monitoring measures should be adjusted [12,13].…”

“…Therefore, it is still necessary to conduct a health economics evaluation of the monitoring measures in Fujian, even though it is in the malaria elimination stage. We reviewed and analyzed the literature on the economics of malaria and found that the differences between the nancial and economic costs were negligible; thus, only economic costs are presented here [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. We calculated costs based on health economics theory and the malaria monitoring measures in this stage.…”