Researcher: Prashant Yadav
Project Sponsor: Roll-Back Malaria Partnership, Geneva
Every year, over a million people die from malaria–most of them children–and hundreds of millions more suffer from disease and disability. Along with the devastating human toll, the economic costs to many African countries are massive. The malaria burden has increased in recent years, in part because inexpensive and widely available anti-malarials such as chloroquine are no longer effective in many regions due to rapidly emerging drug resistance. As a result, in early 2004 the World Health Organization (WHO) recommended that countries adopt a new class of drugs called artemisinin-based combination therapies (ACTs).
The cost of production, and hence the price of ACTs (even on concessional terms) are significantly higher than traditional malaria treatments: 10 cents for an average dose for chloroquine compared to $1 or more for ACTs. An important contributor to the high costs of ACTs is the long (14-month) production cycle, which depends on the agriculture production of a key component, artemisinin, which is then combined with a second compound to hasten recovery and delay the onset of artemisinin-resistant parasites.
While several manufacturers packaged the different drugs together, until early 2007, Novartis was the only company that co-formulated two drugs into a fixed-dose pill (under the brand name Coartem). Under an agreement with WHO, they sold Coartem to developing country governments and international donors at a price set to recover the cost of production; in exchange, they relied on WHO to provide demand forecasts. The long production cycle coupled with a very short shelf life of only 24 months make accurate demand forecasts essential. Unfortunately, the first forecasts provided to the manufacturer from the international community – which were estimates more of need than of effective demand – proved to be off by orders of magnitude. This project is devoted to improve the accuracy of this forecast.
Publications, invited talks and conferences
- “Estimating Demand for Anti-malarials using Willingness to Pay Estimates”. Technical Report 2007. Ongola M. and P. Yadav