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Table 2 Recommendations for calculating and presenting cost results

From: Costing the distribution of insecticide-treated nets: a review of cost and cost-effectiveness studies to provide guidance on standardization of costing methodology

Viewpoint Use societal perspective.
Sub-analyses can focus on specific perspectives such as provider, patient or Ministry of Health
Output Clarify whether intervention delivers nets or treatment or both
Calculate net and treatment costs separately
Resource identification Include all costs of behaviour change activities (including advertising)
Include any costs of treating LLINs in campaigns
Exclude research costs
Include relevant overheads of collaborating organizations (e.g. NGO contributions to procurement, management, etc)
Clarify what management capacity is assumed to exist and whether calculating average cost or incremental cost of adding intervention to an existing programme
Resource measurement Attempt to measure and report leakage of resources (e.g. nets used by individuals outside target groups)
Establish average lifespan of net under local conditions
Resource valuation Treat nets as a capital item.
Base case should assume life expectancy of 3 years and use discount rate of 3% Avoid double counting of user contributions where cost recovery applied, but ensure these are counted as user contributions when disaggregating costs by source
Sensitivity analysis Conduct sensitivity analysis on: discount rate (0%, 5%, 10% at a minimum); frequency of net impregnation, procurement cost of net and insecticide; number of people protected per net; lifespan of net Consider impact of research where this is conducted alongside a programme on programme effectiveness (see ref 5)
Vary proportion of shared resources where distribution carried out as part of another programme/campaign
Reporting of results Provide costs in US$ and local currency
Specify year in which costs calculated/adjusted
Report cost per ITN delivered and cost per person sleeping under a net
Discussion of results Compare costs with per capita government health expenditure to aid assessment of affordability
Be cautious in using cost estimates to scale up, and make explicit assumptions about whether marginal cost constant, increasing or decreasing
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