Effect of artemisinin-based treatment policy on consumption pattern of antimalarials

The purpose of this study was to observe the effect of the 2004 national artemisinin-based malaria treatment policy on consumption pattern of antimalarials. The study was undertaken at the University of Ilorin Teaching Hospital (UITH), Nigeria. Prescription and sales data at our pharmacy outlets were gathered from January to December 2004 and compared with similar data for 2005 after policy introduction in January 2005. Total consumption of antimalarials in 2004 was 23,404 doses, made up of artemisinin-containing medications (ACMs; 18.5%); sulphadoxine-pyrimethamine (SP; 7.1%); chloroquine (CQ; 72.85%); and quinine (QUI; 1.6%), compared with 26,383 doses in 2005, made up of ACMs (50.00%); SP (22.7%); CQ (27.3%); and QUI (0%). Z-tests indicate that these differences in proportions were significant (P < 0.001) for ACMs and SP (increased) and decreased for CQ and QUI. The comparative retail price per dose of these medications was in the order: ACMs > QUI > SP > CQ. These data show increased use of antimalarials, with ACMs overtaking CQ as the dominant antimalarial class purchased from the pharmacies operated by the hospital in the first year of policy implementation. This suggests that cost alone may not be the overriding determinant of specific antimalarial consumption.