Real-World Costs and Cost-Effectiveness of Next-Generation Insecticide Treated Bednets: controlled interrupted time-series based economic evaluations of dual-active ingredient (AI) or piperonyl butoxide (PBO) insecticide-treated bed nets (ITNs) versus pyrethroid-only ITNs for malaria prevention.

The article evaluates new types of insecticide-treated bed nets for malaria prevention across five countries. Chlorfenapyr combined with pyrethroid (C + P) showed the best performance with malaria incidence reduction to 62 percent compared to standard nets. Economic analysis revealed that the cost to prevent one malaria case using C + P nets was 1.51 USD, while adding indoor residual spraying (IRS) cost 18.59 USD per case averted. The research recommends switching from standard nets to nets with dual active ingredients or piperonyl butoxide, with C + P nets considered the most suitable choice. Programs should consider local malaria burden information and current product prices when selecting the most efficient prevention strategy for their settings.