Incentivising Appropriate Malaria Treatment-seeking Behaviour with Price Subsides

Kristian Schultz Hansen, Tine Hjernø Lesner, Lars Peter Østerdal

Publikation: Working paperForskning

Resumé

One of the most serious problems in the fight against malaria, especially in Africa, is the fact that many individuals suffering from malaria do not have easy access to effective antimalarials while at the same time a large proportion of people receiving antimalarials do not suffer from malaria. In order to improve access, a global price subsidy of 95% has been proposed for the most effective antimalarial, artemisinin-based combination therapy (ACT). The objective of this proposal is to lower the consumer price on effective malaria medicine to increase access for, in particular, poor consumers. However, treatment of patients not suffering from malaria with antimalarials including ACTs has been proven widespread and a subsidy is likely to increase this over-treatment. This means waste of resources and will result in inflating the subsidy funds required. In addition, as has happened with older types of malaria medicine, treating non-malarial fevers with malaria medicine may increase the risk of artemisinin resistance development. Diagnostic tests for malaria may have the potential for reducing over-treatment, but tests are expensive for the typical malaria treatment-seeking individual. In order to both increase access and reduce over-treatment we propose a subsidy on rapid diagnostic tests (RDTs) together with the ACT subsidy. The main objective of the paper is to investigate the optimal combination of subsidies that incentivises individuals suspecting themselves to have malaria to always test before buying an effective drug. We present a model that describes the health seeking behaviour of a representative individual using an expected utility framework. Based on numerical simulations of our model we find that a price reduction on RDTs is necessary to incentivise testing while at the same time, the subsidy on ACT can be lower than the proposed 95% without compromising access. The least-cost policy of the health policy maker is to subsidise both ACT and RDT, redirecting some of the subsidy money from ACT to RDT.
OriginalsprogEngelsk
Udgivelses stedOdense
UdgiverSyddansk Universitet
Antal sider31
StatusUdgivet - 2013
Udgivet eksterntJa
NavnCOHERE Discussion Papers
Nummer2013:8
ISSN2246-3097

Citer dette

Schultz Hansen, K., Lesner, T. H., & Østerdal, L. P. (2013). Incentivising Appropriate Malaria Treatment-seeking Behaviour with Price Subsides. Odense: Syddansk Universitet. COHERE Discussion Papers, Nr. 2013:8
Schultz Hansen, Kristian ; Lesner, Tine Hjernø ; Østerdal, Lars Peter. / Incentivising Appropriate Malaria Treatment-seeking Behaviour with Price Subsides. Odense : Syddansk Universitet, 2013. (COHERE Discussion Papers; Nr. 2013:8).
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Schultz Hansen, K, Lesner, TH & Østerdal, LP 2013 'Incentivising Appropriate Malaria Treatment-seeking Behaviour with Price Subsides' Syddansk Universitet, Odense.

Incentivising Appropriate Malaria Treatment-seeking Behaviour with Price Subsides. / Schultz Hansen, Kristian; Lesner, Tine Hjernø; Østerdal, Lars Peter.

Odense : Syddansk Universitet, 2013.

Publikation: Working paperForskning

TY - UNPB

T1 - Incentivising Appropriate Malaria Treatment-seeking Behaviour with Price Subsides

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AU - Lesner, Tine Hjernø

AU - Østerdal, Lars Peter

PY - 2013

Y1 - 2013

N2 - One of the most serious problems in the fight against malaria, especially in Africa, is the fact that many individuals suffering from malaria do not have easy access to effective antimalarials while at the same time a large proportion of people receiving antimalarials do not suffer from malaria. In order to improve access, a global price subsidy of 95% has been proposed for the most effective antimalarial, artemisinin-based combination therapy (ACT). The objective of this proposal is to lower the consumer price on effective malaria medicine to increase access for, in particular, poor consumers. However, treatment of patients not suffering from malaria with antimalarials including ACTs has been proven widespread and a subsidy is likely to increase this over-treatment. This means waste of resources and will result in inflating the subsidy funds required. In addition, as has happened with older types of malaria medicine, treating non-malarial fevers with malaria medicine may increase the risk of artemisinin resistance development. Diagnostic tests for malaria may have the potential for reducing over-treatment, but tests are expensive for the typical malaria treatment-seeking individual. In order to both increase access and reduce over-treatment we propose a subsidy on rapid diagnostic tests (RDTs) together with the ACT subsidy. The main objective of the paper is to investigate the optimal combination of subsidies that incentivises individuals suspecting themselves to have malaria to always test before buying an effective drug. We present a model that describes the health seeking behaviour of a representative individual using an expected utility framework. Based on numerical simulations of our model we find that a price reduction on RDTs is necessary to incentivise testing while at the same time, the subsidy on ACT can be lower than the proposed 95% without compromising access. The least-cost policy of the health policy maker is to subsidise both ACT and RDT, redirecting some of the subsidy money from ACT to RDT.

AB - One of the most serious problems in the fight against malaria, especially in Africa, is the fact that many individuals suffering from malaria do not have easy access to effective antimalarials while at the same time a large proportion of people receiving antimalarials do not suffer from malaria. In order to improve access, a global price subsidy of 95% has been proposed for the most effective antimalarial, artemisinin-based combination therapy (ACT). The objective of this proposal is to lower the consumer price on effective malaria medicine to increase access for, in particular, poor consumers. However, treatment of patients not suffering from malaria with antimalarials including ACTs has been proven widespread and a subsidy is likely to increase this over-treatment. This means waste of resources and will result in inflating the subsidy funds required. In addition, as has happened with older types of malaria medicine, treating non-malarial fevers with malaria medicine may increase the risk of artemisinin resistance development. Diagnostic tests for malaria may have the potential for reducing over-treatment, but tests are expensive for the typical malaria treatment-seeking individual. In order to both increase access and reduce over-treatment we propose a subsidy on rapid diagnostic tests (RDTs) together with the ACT subsidy. The main objective of the paper is to investigate the optimal combination of subsidies that incentivises individuals suspecting themselves to have malaria to always test before buying an effective drug. We present a model that describes the health seeking behaviour of a representative individual using an expected utility framework. Based on numerical simulations of our model we find that a price reduction on RDTs is necessary to incentivise testing while at the same time, the subsidy on ACT can be lower than the proposed 95% without compromising access. The least-cost policy of the health policy maker is to subsidise both ACT and RDT, redirecting some of the subsidy money from ACT to RDT.

M3 - Working paper

BT - Incentivising Appropriate Malaria Treatment-seeking Behaviour with Price Subsides

PB - Syddansk Universitet

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ER -

Schultz Hansen K, Lesner TH, Østerdal LP. Incentivising Appropriate Malaria Treatment-seeking Behaviour with Price Subsides. Odense: Syddansk Universitet. 2013.