OBJECTIVES: The number of malaria cases in the United States (US) has increased in recent years. Few studies have reported costs associated with malaria treatment in the US. To fill this gap, we estimated mean inpatient and outpatient payments for malaria treatment among patients with private and Medicaid insurance.

METHODS: We identified patients with a first diagnosis of malaria from October 2015 to December 2019 in the Merative^® MarketScan^® Databases. We excluded patients 1) with Medicare, 2) with capitated insurance plans, or 3) who were not continuously enrolled between 30 days before and 90 days after the first diagnosis. We categorized patients as hospitalized or non-hospitalized; hospitalized patients were further categorized depending on whether malaria was the primary diagnosis. We estimated mean inpatient and outpatient costs per malaria patient, using reported payments.

RESULTS: We identified 479 malaria patients with private insurance and 64 with Medicaid, of which 64% and 73% were hospitalized, respectively. The mean total costs were $27,642 per hospitalized malaria patient with private insurance and $19,361 per hospitalized patient with Medicaid. Among hospitalized patients with private insurance, the mean total cost per patient was less for those with primary malaria diagnoses ($17,092) compared to non-primary diagnoses ($44,004); inpatient services accounted for most of the total cost (97−99%). The mean total cost per non-hospitalized privately insured patient was $1,177, including outpatient services ($1,088) and prescription drugs ($89). The mean total costs per Medicaid enrollee with malaria were $5,996 and $27,952 for hospitalized patients with primary and non-primary diagnoses, respectively, and $551 for non-hospitalized patients.

CONCLUSIONS: Our findings provide the most recent estimates of U.S.‒specific malaria treatment costs and the first estimates of costs for non-hospitalized patients with malaria. These results may provide important information for evaluating the cost-effectiveness of interventions, such as pre‒travel prevention strategies.