The cost of combination treatment is thought to be one of the greatest
barriers to their deployment, but this has not been tested directly.
Estimates of willingness to pay were compared across four drug
combinations used to treat Tanzanian children with uncomplicated
malaria. The reasons behind respondents' valuations and the effect of
socioeconomic status on willingness to pay were explored.
One hundred and eighty mothers whose children had been recruited into a
recently completed randomized effectiveness trial of amodiaquine +
artesunate AQ+AS;: amodiaquine + sulfadoxine-pyrimethamine AQ+SP;:
artemether-lumefantrine coartemether) and amodiaquine monotherapy AQ)
were interviewed about their willingness to pay for these drugs two
weeks after treatment. Estimates of willingness to pay were elicited
with the bidding game technique.
A significant difference was detected in the mean amounts respondents
were willing to pay, with those who received AQ+AS willing to pay the
most, followed by co-artemether, AQ+SP and finally AQ. The amounts
patients' mothers were willing to pay for the artemisinin-based
combinations, however, fell well short of the market costs.
Socioeconomic status was not found to have a statistically significant
effect on mean willingness to pay scores for any treatment group.
This study shows that families who live in an area in which drug
resistance to monotherapy is very high are willing to pay more for more
effective artemisinin-based combination therapies. These amounts,
however, are nowhere near the real costs of delivering the new drugs.
Only with subsidies will artemisinin-based combination therapies
realistically have any impact.
Bulletin of the World Health Organization (2005) 83 (11) 845-852
Differences in willingness to pay for artemisinin-based combinations or monotherapy: experiences from the United Republic of Tanzania
Published 12 September 2006