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# Safe 7-day primaquine package costs US$6,636 per DALY averted in Indonesia
- URL: https://www.coios.me/safe-7-day-primaquine-package-costs-us-6-636-per-daly/
- Published: 2026-09-27T09:01:18.000Z
- Updated: 2026-09-27T09:59:18.000Z
- Description: A decision-tree model of a G6PD-screening and high-dose primaquine package for Plasmodium vivax radical cure in Indonesia gave an incremental cost-effectiveness ratio of US$6,636 per DALY averted from the health system perspective, above the 1x GDP per capita threshold of US$4,925.
- Author: Daniel Ryan
- Tags: Weighing data and models, Value in health, Indonesia, #preprint, #new, #item, #source-2026-09

A decision-tree model built on individual-level data from patients given 7 mg/kg primaquine dosed by G6PD activity compared a revised case-management package - G6PD screening, targeted high-dose primaquine and early clinical review - with business-as-usual over six months in Indonesia. The package averted 0.0011 DALYs per patient at an incremental health system cost of US$7.40, an ICER of US$6,636 per DALY averted, above the US$4,925 (1x GDP per capita) threshold. Results varied by setting, from US$5,098 per DALY averted in Papua to US$80,825 in northern Sumatra, and fell to US$2,261 nationally when societal costs were included.

*Why it is interesting: Shows how far a single national ICER can conceal variation by transmission setting and by analytic perspective, with recurrence risk the dominant parameter.*

Source

[medRxiv, 25 September 2026](https://doi.org/10.64898/2026.09.23.26363845?ref=coios.me)

DOI

10.64898/2026.09.23.26363845

Type

Preprint

Design

Decision-tree cost-utility model over a six-month horizon using individual-level trial data, with business-as-usual comparator from historical recurrence data, national and three provincial settings

Verdict

New finding

Driver

[Value in health](https://www.coios.me/d-health-economics/)