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The Impact of Subsidized Antimalarials on Treatment Seeking Behavior

Author

Listed:
  • Jacqueline Fiore

    (Department of Economics, Tulane University)

Abstract

I investigate the effect of the first multi-country antimalarial subsidy on the type and source of treatment taken for children under five years of age reporting a fever. I use nationally representative, cross-sectional survey data from 15 malaria endemic African countries over an 11 year period. My research design exploits the within country variation in malaria treatment subsidies. Artemisinin-based Combination Therapies (ACTs) are the recommended first line treatment for uncomplicated malaria. Overall, the ACTs subsidy achieved two of its main objectives. Among children reporting a fever, countries offering subsidized ACTs increased ACTs taken in the private sector by 6.8 percent and decreased treatment with lesser effective antimalarial monotherapies by 9.0 percent. However, the effect of the ACTs subsidy was not consistent among the three participating countries studied. Uganda showed the intended response with the greatest magnitude to the subsidy, whereas no significant effect was observed in Ghana or Nigeria. The mixed results among countries participating in the ACTs subsidy may be due to differences in ACTs availability, price, market share, and supporting interventions.

Suggested Citation

  • Jacqueline Fiore, 2017. "The Impact of Subsidized Antimalarials on Treatment Seeking Behavior," Working Papers 1717, Tulane University, Department of Economics, revised Mar 2018.
    • Handle: RePEc:tul:wpaper:1717
    as

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    File URL: http://repec.tulane.edu/RePEc/pdf/tul1717r.pdf
    File Function: Revised Version, March 2018
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    References listed on IDEAS

    as
    1. Oliver J Sabot & Alex Mwita & Justin M Cohen & Yahya Ipuge & Megumi Gordon & David Bishop & Moses Odhiambo & Lorrayne Ward & Catherine Goodman, 2009. "Piloting the Global Subsidy: The Impact of Subsidized Artemisinin-Based Combination Therapies Distributed through Private Drug Shops in Rural Tanzania," PLOS ONE, Public Library of Science, vol. 4(9), pages 1-7, September.
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    3. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    4. Amy Maxmen, 2012. "Malaria plan under scrutiny," Nature, Nature, vol. 490(7418), pages 13-14, October.
    5. Abadie, Alberto & Diamond, Alexis & Hainmueller, Jens, 2010. "Synthetic Control Methods for Comparative Case Studies: Estimating the Effect of California’s Tobacco Control Program," Journal of the American Statistical Association, American Statistical Association, vol. 105(490), pages 493-505.
    6. Jessica Cohen & Pascaline Dupas & Simone Schaner, 2015. "Price Subsidies, Diagnostic Tests, and Targeting of Malaria Treatment: Evidence from a Randomized Controlled Trial," American Economic Review, American Economic Association, vol. 105(2), pages 609-645, February.
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    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    Malaria; subsidy; Artemisinin-based combination therapies (ACTs); Affordable Medicines Facility-malaria; Private Sector Co-payment Mechanism;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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