Table 2.

Costs, Effects, and ICER values of implementing universal CRAG screening

Intervention	Total Cost (95% UR)a,c	Incremental Costc	DALYs	Incremental Effectiveness (DALYs averted)	ICER (cost per DALY averted)c
No screening	9.24 (7.31to 18.40)	REFERENCE	8.55 (6.70 to 10.90)	REFERENCE	REFERENCE
CRAG screeningb	10.76 (8.39 to 12.29)	1.52 (−5.46 to 9.42)	8.30 (6.41to 10.79)	25 DALYs averted per 100 participants (13 to 47)	6.14 (−20.32 to 36.47)

Abbreviations: CP current practice, CRAG-LFA cryptococcal antigen lateral flow assay, DALY disability adjusted life-year, ICER incremental cost-effectiveness ratio

^aTotal costs represent total health systems costs, inclusive of diagnostic testing and treatment costs related to diagnosed cryptococcal antigenemia and/or cryptococcal meningitis over a 5 year time period, but excludes lifetime ART costs. DALYs were evaluated over a lifelong time horizon. Future years are discounted by 3% and ART costs are not included in base case analysis

^bThe CRAG-LFA intervention consists of screening all cohort patients for cryptococcal antigenemia with CRAG-LFA, followed by cryptococcal pre-emptive therapy (CPET) for those who screen positive

^cIn secondary analysis, the total costs inclusive of lifetime ART costs were $5772 and $5991 (incremental of139.48) for CP and CRAG-LFA screening arms, respectively. The ICER inclusive of lifetime ART costs was 558 per DALY averted