Do Price Subsidies on Artemisinin Combination Therapy for Malaria Increase Household Use? Evidence from a Repeated Cross-Sectional Study in Remote Regions of Tanzania

Jessica L. Cohen, Prashant Yadav, Corrina Moucheraud, Sarah Alphs, Peter S. Larson, Jean Arkedis, Julius Massaga, Oliver Sabot

Research output: Contribution to journalArticlepeer-review

Abstract

Background:The Affordable Medicines Facility-malaria (AMFm) is a pilot program that uses price subsidies to increase access to Artemisinin Combination Therapies (ACTs), currently the most effective malaria treatment. Recent evidence suggests that availability and affordability of ACTs in retail sector drug shops (where many people treat malaria) has increased under the AMFm, but it is unclear whether household level ACT use has increased.Methods and Findings:Household surveys were conducted in two remote regions of Tanzania (Mtwara and Rukwa) in three waves: March 2011, December 2011 and March 2012, corresponding to 3, 13 and 16 months into the AMFm implementation respectively. Information about suspected malaria episodes including treatment location and medications taken was collected. Respondents were also asked about antimalarial preferences and perceptions about the availability of these medications. Significant increases in ACT use, preference and perceived availability were found between Rounds 1 and 3 though not for all measures between Rounds 1 and 2. ACT use among suspected malaria episodes was 51.1% in March 2011 and increased by 10.9 percentage points by Round 3 (p =. 017). The greatest increase was among retail sector patients, where ACT use increased from 31% in Round 1 to 49% in Round 2 (p =. 037) and to 61% (p<.0001) by Round 3. The fraction of suspected malaria episodes treated in the retail sector increased from 30.2% in Round 1 to 46.7% in Round 3 (p =. 0009), mostly due to a decrease in patients who sought no treatment at all. No significant changes in public sector treatment seeking were found.Conclusions:The AMFm has led to significant increases in ACT use for suspected malaria, especially in the retail sector. No evidence is found supporting the concerns that the AMFm would crowd out public sector treatment or neglect patients in remote areas and from low SES groups.

Original languageEnglish (US)
Article numbere70713
JournalPloS one
Volume8
Issue number7
DOIs
StatePublished - Jul 29 2013

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology
  • General Agricultural and Biological Sciences
  • General

Fingerprint

Dive into the research topics of 'Do Price Subsidies on Artemisinin Combination Therapy for Malaria Increase Household Use? Evidence from a Repeated Cross-Sectional Study in Remote Regions of Tanzania'. Together they form a unique fingerprint.

Cite this