Table 5.
Results of Baseline Analysis: Net Costs or Savings due to Pretravel Health Consultations Among Travelers to West Africaa
| Stakeholder Cost Categories by Perspective | Purpose of Travelb and Median Planned Length of Travelc |
|||
|---|---|---|---|---|
| Business 9 d | Leisure 14 d | All Purposes 21 d | VFRb 30 d | |
| Healthcare payer's perspective | ||||
| Weighted average direct cost for treatment, US$d | 25 250 | |||
| Cost of pretravel health consultation, chemoprophylaxis, and treatment of adverse events associated with chemoprophylaxis (Supplementary Appendix Table A2), $ | 161.42 | 189.76 | 207.59 | 207.03 |
| Net cost/savings per person per trip, $e | 13.65 (net savings) | 82.32 (net savings) | 199.14 (net savings) | 371.64 (net savings) |
| (Lower bound, upper bound) | (−212.25, 613.72) | (−240.08, 1003.94) | (−246.79, 1571.12) | (−218.43, 2324.12) |
| Traveler's perspective | ||||
| Weighted average out-of-pocket cost (direct plus indirect) for treatment, $d | 3387 | |||
| Out-of-pocket cost of pretravel health consultation, chemoprophylaxis, and treatment of an adverse event associated with chemoprophylaxis (Supplementary Appendix Table A3), $ | 43.78 | 44.15 | 44.70 | 45.58 |
| Net cost/saving per person per trip, $e | −20.30 (net costs) | −7.66 (net costs) | 9.86 (net savings) | 32.04 (net savings) |
| (Lower bound, upper bound) | (−100.72, 223.21) | (−100.16, 357.19) | (−99.51, 545.19) | (−99.11, 787.85) |
100% adherence for malaria chemoprophylaxis regimens was assumed.
Abbreviation: VFR, visiting friends and relatives.
a Costs were in US 2009 dollars. West Africa included Benin, Burkina Faso, Cape Verde, Côte d'Ivoire, The Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, São Tomé and Príncipe, Senegal, Sierra Leone, and Togo [1]. Travelers to West Africa were identified as those travelers who planned to visit 1 or more countries only in West Africa (Supplementary Appendix Section 1).
b For their pretravel health consultations, travelers were asked to report their purpose(s) of travel from the following (multiple choices were allowed): leisure, business, returning to region of origin of self or family to visit friends and relatives, adoption, providing medical care, receiving medical care, research/education, nonmedical service work, missionary work, military service, adventuring, attending large gathering or event, or other activities [8]. For this analysis, travelers who reported only 1 of the 3 purposes (ie, business, leisure, and VFR) were selected. All purposes denote all travelers to West Africa.
c The median planned length of travel for each category of the purposes of travel was calculated among travelers to West Africa (Supplementary Table A1).
d Treatment cost of a malaria case was a weighted averaged between costs for ambulatory and hospital medical care using the probability of each care among travelers to West Africa as the weight (Table 1).
e A negative value indicates that pretravel health consultation for malaria prevention will result in a net cost to healthcare payer or a traveler, whereas a positive value indicates a net savings to a healthcare payer or a traveler. The lower and upper ranges were calculated by using lower and upper values of input and cost parameters in Tables 1–3.