Table 2.
Costs (US$ 2009) Associated With Pretravel Health Consultations for Malaria Chemoprophylaxis: Healthcare Payer's and Traveler's Perspectives
| Item | Baseline Valuea | Rangea | Reference |
|---|---|---|---|
| Healthcare payer's perspective (direct medical costs) | |||
| Travel clinic visitb | $148.52 | $126.27–$170.77 | [19] |
| Percentage of travel clinic visit costs related to malaria prevention | 14.8% | … | Supplementary Appendix |
| Malaria chemoprophylaxis (per adult dose)c | |||
| Atovaquone/proguanil | $7.87 | $6.40–$11.70d | [20] |
| Doxycycline | $1.08 | $0.43–$1.78d | [20] |
| Mefloquine | $13.17 | $9.46–$18.03d | [20] |
| Physician visit to treat adverse eventse | $80.50 | $69.00–$92.00 | [19] |
| Prescription drug for adverse eventsf | $11.50 | $7.00–$20.00 | [20] |
| Traveler's perspective | |||
| Direct costs | |||
| Copayment for travel clinic visit | $30.00 | $15.00–$170.77g | [5], Assumption |
| Copayment for physician office visit to treat adverse events | $20.00 | $10.00–$50.00 | [21], Assumption |
| Copayment for prescription drug | $25.00 | $10.00–$50.00 | [21], Assumption |
| Indirect costs | |||
| Lost work hours for travel clinic visit (120 min)h | $65.57 | $31.96–$97.32 | [16, 17], Supplementary Appendix |
| Lost work hours for physician visit due to adverse events (60 min)h | $32.79 | $15.98–$48.66 | [16, 17], Supplementary Appendix |
a Baseline and range values were often taken from different resources. We used expert opinion to determine the most representative baseline values, and thus the baseline values are different from the simple middle or median of the range.
b The cost for a travel clinic visit was calculated by using Current Procedural Terminology (CPT) codes in common use by the Global TravEpiNet clinics and the range of allowable billing charges associated with those CPT codes [19].
c The costs were calculated based on the following adult dose regimens: (1) atovaquone/proguanil, 250 mg atovaquone and 100 mg proguanil hydrochloride, 1 tablet orally, daily; (2) doxycycline, 100 mg orally, daily; and (3) mefloquine, 228 mg base (250 mg salt) orally, once a week [1].
d The lower and upper range values were 5th and 95th percentiles of listed wholesale prices, respectively.
e The cost of physician visit was estimated as the average of allowable billing charges of CPT code 99201 (office or other outpatient services, new patient level 1) [19].
f The cost of prescription drug was estimated based on the protocol of prochlorperazine 10 mg, 3 times daily for 4 days, for vomiting and nausea [20].
g In case a traveler is uninsured or his/her health insurance does not cover travel-related preventions, it was assumed the traveler paid the upper limit of $170.77 out-of-pocket costs of a travel clinic visit.
h The costs for lost work hours were calculated with the estimated hourly compensation of $32.79 (Table 1).