American Journal of Pharmacological Sciences
ISSN (Print): 2327-6711 ISSN (Online): 2327-672X Website: http://www.sciepub.com/journal/ajps Editor-in-chief: Srinivas NAMMI
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American Journal of Pharmacological Sciences. 2015, 3(2), 38-43
DOI: 10.12691/ajps-3-2-2
Open AccessArticle

Pharmacoeconomics of Antimalarials in Private-for-Profit (PFP) Drug-Outlets in Gulu and Kitgum Towns, Northern Uganda

Mshilla Maghanga1, , Obai Gerald2 and Musoke David3

1Faculty of Business and Development Studies, Gulu University, P. O. Box 166 Gulu, Uganda

2Department of Physiology, Faculty of Medicine, Gulu University, P. O. Box 166 Gulu, Uganda

3Department of Pharmacology, Faculty of Medicine, Gulu University, P. O. Box 166 Gulu, Uganda

Pub. Date: April 29, 2015

Cite this paper:
Mshilla Maghanga, Obai Gerald and Musoke David. Pharmacoeconomics of Antimalarials in Private-for-Profit (PFP) Drug-Outlets in Gulu and Kitgum Towns, Northern Uganda. American Journal of Pharmacological Sciences. 2015; 3(2):38-43. doi: 10.12691/ajps-3-2-2

Abstract

Background: Clinically-diagnosed malaria is the leading cause of morbidity and mortality in Uganda accounting for 25 to 40% of outpatients, 15 to 20% of all hospital admissions, and 9 to 14% of all hospital deaths. This situation was exacerbated by The Lord’s Resistance Army (LRA) rebellion in northern Uganda which completely ran down the health care system. While malaria remains the number one killer disease in northern Uganda, antimalarials are lacking in the public health facilities. Consequently, Private-for-profit drug-outlets have come up to help bridge the gap. However, the cost-effectiveness and treatment outcome ratings of antimalarials are not clear. Objective: To assess the pharmacoeconomics of malaria treatment in Private-for-profit (PFP) drug-outlets in Gulu Municipality and Kitgum Town Council. Methodology: This was a descriptive cross-sectional study sites were registered drug outlets. Study participants were drug-outlet owners, their employees, and malaria patients. We employed both purposive and random sampling methods to select the study participants. Data were collected using questionnaires and analysed using the SPSS computer package. Results: Up to 91.1% of the respondents indicated that antimalarials are expensive. The prices varied from less than 5,000 to over 20,000 Ugandan shillings per dose (Exchange rate: 1$ = Ush 2,650). Fansidar and chloroquine were rated as being relatively cheap and ACTs expensive (Ush 11,000 to 15,000). Duration of treatment, frequency of administration, needles and syringes, raised the cost of some medicines. Most patients preferred cheap medicines (76.2%); those with low administration frequencies (77.5%); and those with short treatment duration (95%). Most patients (80.9%) buy antimalarials without testing, while 66.6% do not buy full doses. Conclusion: The cost benefit analysis of the use of antimalarials is unfavourable. The unit price of the medicines, their irrational use and the lack of professionals in the outlets together add up to high overall costs and poor treatment outcomes.

Keywords:
malaria pharmacoeconomics northern Uganda private-for-profit drug outlets ACTs

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References:

[1]  Amin, A.A., Zurovac, D., Kangwana, B.B, Greenfield, J., Otieno, D.N.,et al., (2007): The challenges of changing national malaria drug policy to artemisinin-based combinations. Malaria Journal (2007) 6: 72.
 
[2]  Barbara Among Uganda improves on UN MDGs Monday, 6th December, 2010.
 
[3]  Carswell, Christopher I., and Paladino, Joseph A. (2010). PharmacoEconomics, Volume 29 - Issue 2. ISSN: 1170-7690. Online ISSN: 1179-2027. Retrieved January 18th, 2011 from http://adisonline.com/pharmacoeconomics/Pages/default.aspx.
 
[4]  Hetzel, MW., Msechu, JJ., Goodman, C., Lengeler, C., Obrist, B., Kachur, SP., Makemba, A., Nathan, R., Schulze, A., Mshinda, H (2006): Decreased availability of antimalarials in the private sector following the policy change. Malar J (2006) 5: 109.
 
[5]  Malaria Consortium (Uganda): Retrieved 18th January, 2011 from http://www.malariaconsortium.org/pages/uganda
 
[6]  Medicines for Malaria Venture (MMV) and Ministry of Health (2007). Understanding the Amtimalarials Market: Uganda 2007 – An Overview of the supply side. Retrieved 20th June, 2011 from http://www.mmv.org/article.php3?id_article=536&recherche=uganda.
 
[7]  MoH (2005): Uganda Malaria Control Strategic Plan 2005/06 – 2009/10: Malaria Control Programme, Kampala.
 
[8]  Ogwang, Martin 2008). Malaria in a conflict zone in Northern Uganda: Results from research and implications for development. Retrieved 18th January, 2011 from http://www.oeaw.ac.at/shared/news/2008/pdf/folder_8_5_2008.pdf.
 
[9]  President’s Malaria Initiative [PMI] (2010): Retrieved 18th January, 2011 from http://www.fightingmalaria.gov/countries/profiles/uganda_profile.pdf.
 
[10]  The Malaria Control Programme (MCP): Retrieved 16th January, 2011 from http://www.health.go.ug/mcp/index2.html.
 
[11]  UNICEF. (2009). The State of the World’s Children 2009. Retrieved 16th January, 2011 from http://www.unicef.org/sowc09/report/report.php.
 
[12]  Walley, Tom (2003): Pharmacoeconomics and Economic Evaluation of Drug Therapies. Retrieved 18th January, 2011 from http://www.iuphar.org/pdf/hum_67.pdf.
 
[13]  Yeka, A., G Dorsey, MR Kamya, A Talisuna, M Lugemwa, JB Rwakimari, et al., (2008): Artemether-lumefantrine versus dihydroartemisinin-piperaquine for treating uncomplicated malaria: a randomized trial to guide policy in Uganda. PLoS ONE (2008) 3: e2390.
 
[14]  Zurovac, D., Tibendarana, JK., Nankabirwa, J., Ssekitooleko, J., Njogu, JN., et al., (2008): Malaria case-management under artemether-lumefantrine treatment policy in Uganda. Malaria Journal 2008, 7:18.