Economic modelling to improve the management of malaria

A single infectious bite with vivax malaria can cause multiple malaria episodes through dormant liver parasites. Radical cure is needed to clear these liver parasites, but the drug can cause haemolysis in individuals with glucose-6-phosphate-dehydrogenase (G6PD) deficiency. Up until recently, options for point-of-care tests for G6PD deficiency have been limited. We have developed decision analytic models to evaluate the cost-effectiveness of vivax malaria patient management, including G6PD screening strategies and radical cure regimens. See our online tools on the cost-effectiveness of screening before primaquine treatment (link). In addition to our patient-level cost-effectiveness analyses alongside clinical trials and implementation studies, we have developed a transmission model that incorporates both vivax and falciparum malaria. This enables us to examine how interventions might have differing impacts across species in addition to evaluating their cost-effectiveness.

Selected publications

Peixoto HM, Bastos Gottin LL, de Brito-Sousa JD, Sampaio V, Daumerie PG, Jambert E, Monteiro WM, Lacerda MVG, Devine A. The cost-effectiveness of tafenoquine following screening with STANDARDTM G6PD screening for the treatment of vivax malaria in the Brazilian Public Health System. Lancet Regional Health - Americas 2025; 51:101216, 1-10.

Abraham P, Lubis IN, Noviyanti R, Trianty L, Nisa FA, Kariodimedjo P, Amalia R, Cahyadi RAD, Qorny TMA, Perlambang R, Surendra H, Anstey N, Grigg MJ, Devine A (joint senior author). The household economic burden of human-only and zoonotic malaria, compared to other causes of acute febrile illness in Indonesia. BMJ Global Health 11:e020504, 1-11.

Setiawan E, Devine A, Sugairsih, Prameswari HD, Baird JK, Price RN, Thriemer K. Malaria Morbidity, Mortality, and Hospitalization Costs in Indonesia: Analysis of National Health Insurance Claim Datasets. BMJ Global Health 2025; 10:e018255, 1-9.

Abraham P, McMullin C, William T, Rajahram GS, Jelip J, Teo R, Drakeley C, Manah AM, Anstey NM, Grigg MJ, Devine A (joint senior author). Household costs associated with zoonotic Plasmodium knowlesi, P. falciparum, P. vivax, and P. malariae episodes in Sabah, Malaysia. PLoS Negl Trop Dis 2025; 19(4):e0012180, 1-17.

Price DJ, Nekkab N, Monteiro WM, Villela DAM, Simpson JA, Lacerda MVG, White M, Devine A. The cost-effectiveness of tafenoquine following G6PD screening for the treatment of vivax malaria in Brazil: a transmission model analysis. PLOS Medicine 2024; 21(1):e1004255, 1-17

Walker CR, Hickson RI, Chang E, Ngor P, Sovannaroth S, Simpson JA, Price DJ, McCaw JM, Price RN, Flegg J, Devine A. A model for malaria treatment evaluation in the presence of multiple species. Epidemics 2023; 44:100687, 1-9.

Devine A, Battle KE, Meagher N, Howes RE, Dini S, Gething P, Simpson JA, Price RN, Lubell Y. Global economic costs due to vivax malaria and the potential impact of its radical cure: A modelling study. PLoS Medicine 2021; 18(6):e1003614, 1-20.

Agius PA, Cutts JC, Win Han Oo, Aung Thi, O'Flaherty K, Kyaw Zayar Aung, Htin Kyaw Thu, Poe Poe Aung, Myat Mon Thein, Nyi Nyi Zaw, Wai Yan Min Htay, Aung Paing Soe, Razook Z, Barry AE, Win Htike, Devine A, Simpson JA, Crabb BS, Beeson JG, Pasricha N, Fowkes FJI. Evaluation of the effectiveness of topical repellent distributed by village health volunteer networks against Plasmodium spp. infection in Myanmar: a stepped-wedge cluster randomised trial. PLoS Medicine 2020; 17(8):e1003177, 1-21.

Devine A, Howes RE, Price DJ, Moore KA, Ley B, Simpson JA, Dittrich S, Price RN. Cost-effectiveness analysis of sex-stratified Plasmodium vivax treatment strategies using available G6PD diagnostics to accelerate access to radical cure. AJTMH 2020; 103(1):394-403. [ABCF, 80%]

Devine A, Pasaribu AP, Teferi T, Pham HT, Awab GR, Contantia F, Nguyen TN, Ngo VT, Tran H, Hailu A, Gilchrist K, Green JA, Koh GCKW, Thriemer K, Taylor WR, Day NPJ, Price RN, Lubell Y. Provider and household costs of vivax malaria episodes: A multicountry comparative analysis of primary trial data. WHO Bulletin 2019; 97(12):828-836.