[Expansion of the use of technologies to reduce cases of malaria due to Plasmodium vivax in the Brazilian Amazon: a budget impact analysis].

Tafenoquine and primaquine are drugs used in the treatment of malaria due to Plasmodium vivax, but can cause hemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency. Thus, G6PD testing is recommended prior to drug administration. Tafenoquine and the G6PD quantitative point-of-care test are incorporated into the Brazilian Unified National Health System (SUS) for individuals over 16 years of age, but are not available for younger patients or by weight range. Testing for all patients eligible for primaquine treatment is also not offered in the SUS. The aim of the present study was to calculate the incremental budgetary impact of the incorporation of tafenoquine and testing for G6PD deficiency in individuals under 16 years of age and by weight. The expansion of testing for patients eligible for treatment with primaquine was also considered. The perspective of the analysis is that of the SUS for a five-year horizon. The reference population was that of the Brazilian Amazon. A budget impact model was developed and validated by managers and specialists in malaria and pharmaceutical services in the SUS. The incremental budget impact was BRL 12.5 million. The model predicted that incorporating tafenoquine would reduce hospitalization and recurrence costs by about 9% and 11%, respectively. The cost and waste of the test reagent strips impacted the results. The technologies analyzed can contribute to safer decision-making in the treatment of malaria in the Brazilian Amazon and planning if the technologies under analysis are incorporated.