Table 3.
Costs and Parameter Estimates for Sensitivity Analysis
| Parameter | Baseline | Minimum–Maximum | Distribution | Reference |
|---|---|---|---|---|
| Cost, RHD management | ||||
| Per‐episode costs | ||||
| ARF/RHD outpatient diagnosis | $1428 | $428–$4564 | Triangular | Table S1 |
| ARF/RHD hospital admission | $11 471 | $8661–$30 200 | Dirichleta | Table S2 |
| RHD surgery | $88 126 | $46 503–$138 749 | Triangular | Table S3 |
| Annual costs (outpatient management) | Table S4 | |||
| Inactive | $198 | $164–$231 | Triangular | |
| Mild RHD | $2567 | $1676–$4233 | Triangular | |
| Moderate RHD | $3267 | $1843–$6534 | Triangular | |
| Severe RHD | $4732 | $3368–$11 976 | Triangular | |
| Severe‐surgery RHD | $4732 | $3368–$13 809 | Triangular | |
| Cost—RHD screening | Table S5 | |||
| Annual costs | ||||
| Equipmentb | $37 045 | Not varied | ··· | |
| Admin and consumables | $5500 | $4500–$6500 | Triangular | |
| Staff salaries | $259 000 | $216 100–$297 000 | Triangular | |
| Travel (Echo A) | $221 270 | $156 524–$270 782 | Triangular | |
| Travel (Echo B) | $136 399 | $89 274–$206 115 | Triangular | |
| Per‐episode costs | ||||
| Cardiology follow‐up (per child) | $1260 | $260–$2324 | Triangular | |
| Other parameter estimates | ||||
| Discount factor | 5% | 3–7% | Uniform | PBAC22 |
| Incidence of RHD (cases per year) | 27.6 | 22.1–33.2 | Uniform | Figure S1 |
| Health state transition probabilities | Bootstrap | Cannon et al9 | ||
| Disability weights | Table 2 | |||
| Mild | 0.031 | 0.017–0.050 | Triangular | |
| Moderate | 0.037 | 0.021–0.058 | Triangular | |
| Severe (no surgery) | 0.186 | 0.128–0.261 | Triangular | |
| Severe after surgery | 0.070 | 0.044–0.102 | Triangular | |
| Screening parameters | ||||
| Screened, % | 75% | 50–100% | Uniform | Assumed |
| Sensitivity of echo | 100% | 95–100% | Uniform | Assumed |
| Diagnosed mild, % | 80% | 65–95% | Dirichletc | Assumed |
| Diagnosed moderate, % | 15% | 5–25% | Dirichletc | Assumed |
| Diagnosed severe, % | 5% | 0–10% | Dirichletc | Assumed |
| Cardiology follow‐up, % | 2.5% | 2–5% | Uniform | Assumed |
All costs are presented in Australian dollars at 2013 price levels. ARF indicates acute rheumatic fever; PBAC, Pharmaceutical Benefits Advisory Council; RHD, rheumatic heart disease.
A Dirichlet distribution was used to sample the proportion of mild (n=10), moderate (n=7), and severe (n=1) cases, based on severity of new cases in our screening study.10
Annuity in advance over 5 years calculated as the upfront cost ($182 720) minus discounted resale price of 10% purchase price.
A Dirichlet distribution was used to sample the proportion of cases admitted with Australian refined diagnosis‐related groups F69A (n=12), F69B (n=47), F75A (n=4), F75B (n=33), F75C (n=113), I66A (n=10), and I66B (n=140), derived from Royal Darwin Hospital admission data 2008–2013.