This study aims to evaluate the cost effectiveness of a provincial or national change to CAT as first line malaria therapy . A change in first line treatment is usually warranted when resistance to a drug becomes unacceptably high. The increase in drug resistance in Africa has had, and will increasingly have a major impact on increased malaria treatment costs 9 . Widespread use of artesunate may potentially reduce transmission to the extent that current vector control programs could be reduced. These potential savings will however will not be included in the analysis, as the extent to which artesunate will eliminate this need may not be evaluable over the 5 year study period.
Limited data are available on resistance growth rates, especially outside of Thailand.
This increase in resistance may result in cost increases, as a result of an increase in outpatient and inpatient cases, and higher acquisition costs of replacement antimalarials. Consequently, should CAT result in a delay in the emergence of resistance, this would potentially result in cost savings.