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Table 6 One-way sensitivity analysis summary for year 1 costs *

From: Cost-effectiveness analysis of malaria rapid diagnostic test incentive schemes for informal private healthcare providers in Myanmar

Parameter

Value (Low, high of range)

Order**

ICERs ($/DALY averted)

Low, high of range

2 nd vs 1 st

3 rd vs 2 nd

4 th vs 3 rd

Inputs that affect costs and health outcomes

Base case

N/A

C, 1, 2, 3

$1,169

$185

$200

Probability of using RDT in arm 1 (base case 0.02)

0.00

C, 1, 2, 3

$1,389

$53

$200

0.65

C, 2, 1, 3

1,159

$45

Dominated (DOM)

Probability of using RDT in arm 2 (base case 0.02)

0.00

C, 2, 1, 3

$1,390

$39

$200

0.65

C, 1, 3, 2

$1,169

$3

$2

Probability of using RDT in arm 3 (base case 0.08)

0.02

C, 1, 2, 3

$1,169

$185

$317

0.65

C, 1, 2, 3

$1,169

$185

$72

Number of febrile patients seeking care per private sector provider per month (base case 40)

1

C, 1, 2, 3

$23,046

$1,939

$3,323

40

C, 1, 2, 3

$594

$139

$118

Probability of ‘no anti-malarial’ administration for clinical diagnosis, arm 1 (base case 0.81)**

0.5

C, 2, 1, 3

$1,159

$34

DOM

0.93

C, 1, 2, 3

DOM

$1,159

$200

Probability of ‘no anti-malarial’ administration for clinical diagnosis, arm 2 (base case 0.81)***

0.5

C, 1, 2, 3

$1,169

$35

DOM

0.93

C, 2, 1, 3

DOM

$1,169

$200

Probability of ‘no anti-malarial’ administration for clinical diagnosis, arm 3 (base case 0.74)***

0.5

C, 1, 2, 3

$1,169

$185

$93

0.93

C, 1, 2, 3

$1,169

$185

DOM

Probability of ACT administration for clinical diagnosis, no intervention (base case 0.05)***

0.05

C, 1, 2, 3

$1,169

$185

$200

0.4

C, 1, 2, 3

DOM

$200

$200

Inputs that affect costs only

     

Programme costs per febrile individual (base case $0 for C, $3.61 for arms 1 and 2, and $4.23 for arm 3)

$2

C, 1, 2, 3

$655

$92

$36

$10

C, 1, 2, 3

$3,204

$92

$36

Cost of ‘no anti-malarial’ (base case $0.58)

$0.30

C, 1, 2, 3

$1,178

$194

$205

$1.00

C, 1, 2, 3

$1,156

$272

$193

Cost of ACT, same across all arms (base case $1.65)

$0.50

C, 2, 1, 3

$1,148

$179

$99

$2.50

C, 1, 2, 3

$1,186

$199

$214

Probability of using RDT for no intervention (base case 0.02)

0.02

C, 1, 2, 3

$1,169

$185

$200

0.11

C, 1, 2, 3

$4,183

$185

$200

Cost of other anti-malarial, same across all arms (base case $0.55)

$0.18

C, 1, 2, 3

$1,165

$179

$200

$1.65

C, 1, 2, 3

$1,183

$201

$201

Inputs that affect health outcomes only

     

Probability of death for non-malarial fever given no anti-malarial (base case 0.0016)

0.001

C, 1, 2, 3

$1,873

$297

$247

0.05

C, 1, 2, 3

$37

$6

$12

Probability of death for non-malarial fever given ACT (base case 0.002)

0.001

C, 1, 2, 3

$846

$140

$153

0.05

C, 1, 2, 3

DOM

DOM

DOM

Percentage of febrile illnesses that are malaria (base case 8%)

3%

C, 1, 2, 3

$7,825

$1,363

$787

20%

C, 1, 2, 3

$384

$60

$72

Probability of death for non-malarial fever given other anti-malarial (base case 0.002)

0.001

C, 1, 2, 3

$940

$141

$198

0.05

C, 1, 2, 3

DOM

DOM

DOM

Discount rate (base case 3%)

0%

C, 1, 2, 3

$673

$106

$117

5%

C, 1, 2, 3

$1,592

$253

$269

Probability of death for P. falciparum malaria given no anti-malarial (base case 0.03)

0.005

C, 1, 2, 3

DOM

DOM

$9.960

0.04

C, 1, 2, 3

$829

$128

$149

Life expectancy in Myanmar (base case 62)

50

C, 1, 2, 3

$1,475

$234

$252

80

C, 1, 2, 3

$974

$153

$166

  1. *Year 1 costs are sufficient to describe the relative differences between the arms, which do not change in subsequent years. Results are based on cut-offs: 25 DALYs and/or $100 per 1,000 individuals. Italics = inputs that affect the order of ICERs.
  2. **Order of ICERs based on cost, from least to most expensive. C = no intervention. 1 = arm 1, 2 = arm 2, 3 = arm 3, skipping over DOM (dominant). ***Holding other anti-malarial constant.
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Malaria Journal

ISSN: 1475-2875

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