Socioeconomic Impact of Artemether-Lumefantrine in Malaria Treatment across Sub-Saharan Africa: A Model-Based Historical Analysis with 2022 as Reference Year.

Abstract

Malaria remains one of the most significant global health challenges in sub-Saharan Africa (SSA), resulting in social and economic consequences owing to high morbidity and mortality. This study aims to determine the socioeconomic burden of malaria as well as the socioeconomic benefit of artemether-lumefantrine (AL, Coartem®, Novartis, Basel, Switzerland) treatment of uncomplicated malaria in SSA. A de novo Microsoft® Excel-based model study was considered for societal perspective assessment. The model included malaria prevalence from SSA countries and focused on three age groups: younger than 5 years old, 5-14 years old, and 15 years old and older. The socioeconomic burden was assessed as loss in paid work productivity attributable to the health burden of malaria as measured in disability-adjusted life years (DALYs), whereas the socioeconomic benefit of AL was measured as avoided productivity loss by utilizing a decision tree. Input parameters used for the calculation were obtained from the published literature, public databases, and the Institute for Health Metrics and Evaluation. For 2022, the model reported 30.8 million malaria-related DALYs in those 15 years old and older, which led to a socioeconomic burden of approximately U.S. $82.8 billion. The estimated total socioeconomic benefit of AL compared with the nontreatment scenario was U.S. $24.2 billion. The estimate reflects avoided productivity losses, including productive years of life lost (YLL) and caregiving days required. In conclusion, these findings highlight the substantial socioeconomic burden of malaria and suggest that by avoiding deaths, reducing YLL, and minimizing caregiving days, AL provides a substantial socioeconomic benefit in the SSA region.