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Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono District, Uganda.

Hansen KS, Pedrazzoli D, Mbonye A, Clarke S, Cundill B, Magnussen P, Yeung S - Health Policy Plan (2012)

Bottom Line: The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation.Factors associated with WTP were investigated using linear regression.The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT.

View Article: PubMed Central - PubMed

Affiliation: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK. Kristian.Hansen@lshtm.ac.uk

ABSTRACT
In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures.

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Relationship between price and the proportion of drug shop customersa willing to pay at least the presented price in UGX (UGX2010 = US$1)b for an RDT, a course of ACT and a course of ACT after a positive RDT, Mukono District, June–July 2009 Notes: a5, 17 and 19 out of 519 drug shop customers had missing values or refused to state a WTP for an RDT, a course of ACT and a course of ACT after a positive RDT, respectively. bAverage exchange rate during 2009 (www.oanda.com).
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czs048-F1: Relationship between price and the proportion of drug shop customersa willing to pay at least the presented price in UGX (UGX2010 = US$1)b for an RDT, a course of ACT and a course of ACT after a positive RDT, Mukono District, June–July 2009 Notes: a5, 17 and 19 out of 519 drug shop customers had missing values or refused to state a WTP for an RDT, a course of ACT and a course of ACT after a positive RDT, respectively. bAverage exchange rate during 2009 (www.oanda.com).

Mentions: Figure 1 displays the proportion of drug shop customers willing to pay a given price or more for the proposed services. The hypothetical demand for an RDT falls quickly as price increases. For example, 64% of the drug shop customers have a WTP of UGX1000 (US$0.50) or above, while only 26% of customers have a WTP of UGX2000 (US$1.00) or above. The hypothetical demand for ACTs falls more gradually and there is considerable overlap between the two curves for WTP for a course of ACT with or without malaria confirmed by an RDT. Among drug shop customers, 90% were willing to pay UGX2000 (US$1.00) or more for a course of ACT, while 93% were willing to pay this amount or more for an ACT if malaria had been confirmed by an RDT first. Similarly, 27% of customers were willing to pay UGX6000 (US$2.99) or more for a course of ACT and 32% were willing to pay this amount for an ACT after confirmation of malaria by an RDT.Figure 1


Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono District, Uganda.

Hansen KS, Pedrazzoli D, Mbonye A, Clarke S, Cundill B, Magnussen P, Yeung S - Health Policy Plan (2012)

Relationship between price and the proportion of drug shop customersa willing to pay at least the presented price in UGX (UGX2010 = US$1)b for an RDT, a course of ACT and a course of ACT after a positive RDT, Mukono District, June–July 2009 Notes: a5, 17 and 19 out of 519 drug shop customers had missing values or refused to state a WTP for an RDT, a course of ACT and a course of ACT after a positive RDT, respectively. bAverage exchange rate during 2009 (www.oanda.com).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3584993&req=5

czs048-F1: Relationship between price and the proportion of drug shop customersa willing to pay at least the presented price in UGX (UGX2010 = US$1)b for an RDT, a course of ACT and a course of ACT after a positive RDT, Mukono District, June–July 2009 Notes: a5, 17 and 19 out of 519 drug shop customers had missing values or refused to state a WTP for an RDT, a course of ACT and a course of ACT after a positive RDT, respectively. bAverage exchange rate during 2009 (www.oanda.com).
Mentions: Figure 1 displays the proportion of drug shop customers willing to pay a given price or more for the proposed services. The hypothetical demand for an RDT falls quickly as price increases. For example, 64% of the drug shop customers have a WTP of UGX1000 (US$0.50) or above, while only 26% of customers have a WTP of UGX2000 (US$1.00) or above. The hypothetical demand for ACTs falls more gradually and there is considerable overlap between the two curves for WTP for a course of ACT with or without malaria confirmed by an RDT. Among drug shop customers, 90% were willing to pay UGX2000 (US$1.00) or more for a course of ACT, while 93% were willing to pay this amount or more for an ACT if malaria had been confirmed by an RDT first. Similarly, 27% of customers were willing to pay UGX6000 (US$2.99) or more for a course of ACT and 32% were willing to pay this amount for an ACT after confirmation of malaria by an RDT.Figure 1

Bottom Line: The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation.Factors associated with WTP were investigated using linear regression.The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT.

View Article: PubMed Central - PubMed

Affiliation: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK. Kristian.Hansen@lshtm.ac.uk

ABSTRACT
In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures.

Show MeSH
Related in: MedlinePlus