Table 1. Cost estimate sources and sensitivity analysis.

Estimate	Source	Description/adaptation	Sensitivity analysis
Number of people with epilepsy requiring treatment	Previously conducted door-to-door survey5	Extrapolated findings and assumed no treatment offered to individuals seizure free for more than 1 year off treatment	We assessed a 10% reduction in number of PWE in urban vs. rural region (survey data is from rural)
Labor costs: primary and Secondary levels	Reports from Ministry of Health6,7	Marginal costs of labor	We assessed a 20% increase in staffing costs
Labor costs: tertiary level	Estimated based upon costs for specialist consultant time + nurse time	Assumed new patient requires 30 minutes and follow-up 15 minutes from consultant and that each visit requires 10 minutes of nursing staff time. Estimates based upon actual salaries and number of patients seen in an epilepsy clinic session at University Teaching Hospital.	We evaluated the effect of increasing the number of annual visits at the tertiary level from annually to quarterly. Assumes patient is referred back to primary level for continuing care.
Diagnostic tests: primary and secondary level	Reports from Ministry of Health6,7	Marginal costs for diagnostic tests	Not applicable
Diagnostic tests:tertiary level	Estimates based upon costs estimated from tertiary care clinic	Includes head CT, but not EEG	Not applicable
Capital expenses:primary and secondary levels	Average facility capital costs (facility maintenance, power, etc.)	Estimated proportionate usage	We assessed the impact of proportionate usage ranging from 0.1–3%.
Capital expenses: tertiary level	Estimated rental and utilization costs for space within tertiary facility	Assumes specialty clinic sole usage is epilepsy care	Not applicable
Medication purchasing	Published costs for 20078	Assumes purchasing in bulk for best prices.	We compared the least vs. most expensive wholesale listed purchase price of first line AED at primary healthcare level
Medication distribution	2010 Zambian Medical Stores Annual Budget	Proportionate costing	We estimated costs based upon proportionate usage ranging from 0.1–3%
Training	Program to train 10% of staff at primary care clinics in the basic treatment of epilepsy	1 week course and training materials to be held in each province for skilled workers at the primary health care centers.	Not applicable
Social marketing to increase care seeking (annual campaign)	Estimates based upon costs of existing social marketing program	Includes radio, TV, posters, etc.	Not applicable

PWE, people with epilepsy; CT, computed tomography; EEG, electroencephalogram.