Table 9.
Effect of different levels of capital investment on cost-effectiveness of blood culture monitoring and evidence-based antimicrobials
| All of Africa | ||||||||
|---|---|---|---|---|---|---|---|---|
| Initial capital investment, $ | Number of blood cultures per annum | Interest rate, % | Generic antimicrobials | Blood culture monitoring + evidence-based antimicrobials | Difference in expected cost per patient, $ | ICER, $ | ||
| Expect cost per patient generic antimicrobials, $ | Cost of negative blood culture, $ | Cost of positive blood culture, $ | Expected cost per patient evidence based, $ | |||||
| 25,000 | 1,000 | 0 | 7.26 | 13.41 | 73.96 | 34.19 | 27.35 | 5,124 |
| 3 | 7.26 | 13.69 | 74.24 | 34.47 | 27.63 | 5,175 | ||
| 5 | 7.26 | 13.88 | 74.43 | 34.66 | 27.82 | 5,175 | ||
| 10 | 7.26 | 14.37 | 74.92 | 35.15 | 28.31 | 5,303 | ||
| 5,000 | 0 | 7.26 | 11.81 | 72.36 | 32.59 | 25.75 | 4,824 | |
| 3 | 7.26 | 11.87 | 72.42 | 32.65 | 25.81 | 4,834 | ||
| 5 | 7.26 | 11.90 | 72.45 | 32.69 | 25.85 | 4,842 | ||
| 10 | 7.26 | 12.00 | 72.55 | 32.79 | 25.95 | 4,860 | ||
| 50,000 | 1,000 | 0 | 7.26 | 16.41 | 76.96 | 37.19 | 30.35 | 5,686 |
| 3 | 7.26 | 17.10 | 77.65 | 37.88 | 31.04 | 5,815 | ||
| 5 | 7.26 | 17.58 | 78.13 | 38.36 | 31.52 | 5,904 | ||
| 10 | 7.26 | 18.81 | 79.36 | 39.59 | 32.75 | 6,135 | ||
| 5,000 | 0 | 7.26 | 12.41 | 72.96 | 33.19 | 26.35 | 4,936 | |
| 3 | 7.26 | 12.55 | 73.10 | 33.33 | 26.49 | 4,962 | ||
| 5 | 7.26 | 12.64 | 73.19 | 33.43 | 26.59 | 4,980 | ||
| 10 | 7.26 | 12.89 | 73.44 | 33.67 | 26.83 | 5,026 | ||
| 100,000 | 5,000 | 0 | 7.26 | 13.41 | 73.96 | 34.19 | 27.35 | 5,124 |
| 3 | 7.26 | 13.69 | 74.24 | 34.47 | 27.63 | 5,175 | ||
| 5 | 7.26 | 13.88 | 74.43 | 34.66 | 27.82 | 5,211 | ||
| 10 | 7.26 | 14.37 | 74.92 | 35.15 | 28.31 | 5,303 | ||
| 10,000 | 0 | 7.26 | 12.41 | 72.96 | 33.19 | 26.35 | 4,936 | |
| 3 | 7.26 | 12.55 | 73.10 | 33.33 | 26.49 | 4,962 | ||
| 5 | 7.26 | 12.64 | 73.19 | 33.43 | 26.59 | 4,980 | ||
| 10 | 7.26 | 12.89 | 73.44 | 33.67 | 26.83 | 5,026 | ||
ICER = incremental cost-effectiveness ratio.
All scenarios use all of Africa base-case values for both generic and evidence-based cases. Capital investment costs are added as annualized per patient costs to the base-case cost of blood culture monitoring and evidence-based antimicrobials, set at $71.96 per patient.