Table 3. Sensitivity to selected parameters of the incremental cost-effectiveness ratio (ICER) of replacing presumptive diagnosis by rapid diagnostic tests in drug shops in Mukono District, Uganda, 2011 (US$1 = UGX2523).
Parameter & | --- ICER in US$ --- | Parameter & | --- ICER in US$ --- | ||
---|---|---|---|---|---|
Health sector | Societal | Health sector | Societal | ||
Malaria prevalence among customers (43% and 32%) | Prob. of subs. treatment in mRDT arm (9.8%) | ||||
10% | -0.09 | 2.72 | 2% | 0.55 | 3.34 |
20% | 0.08 | 3.21 | 20% | 0.55 | 4.47 |
40% | 0.61 | 4.82 | 35% | 0.55 | 5.40 |
60% | 1.92 | 8.72 | Prob. of subs. treatment in presumptive arm (10.2%) | ||
80% | 9.72 | 32.03 | 2% | 0.55 | 4.20 |
Sensitivity of mRDT (92%) | 20% | 0.55 | 3.39 | ||
70% | 0.28 | 4.61 | 35% | 0.55 | 2.71 |
85% | 0.48 | 4.04 | ACT price | ||
100% | 0.63 | 3.61 | 30% decrease | 1.02 | 4.30 |
Specificity of mRDT (63%) | 40% decrease | 1.18 | 4.46 | ||
50% | 0.98 | 4.75 | 50% decrease | 1.34 | 4.61 |
70% | 0.37 | 3.44 | mRDT price (US$0.70) | ||
90% | 0.00 | 2.63 | 30% decrease | -0.08 | 3.20 |
100% | -0.14 | 2.33 | 40% decrease | -0.29 | 2.99 |
Adherence to negative mRDT (99%) | 50% decrease | -0.50 | 2.78 | ||
40% | 2.49 | 7.61 | Discount rate (3%) | ||
60% | 1.56 | 5.81 | 1% | 0.56 | 3.84 |
80% | 0.96 | 4.63 | 7% | 0.54 | 3.82 |
Change in number of customers in mRDT arm | 10% | 0.53 | 3.81 | ||
40% lower | 2.21 | 5.49 | Com. sens., training and intense sup. (every 5 years) | ||
40% higher | -0.16 | 3.12 | Every 3 years | 0.49 | 3.77 |
80% higher | -0.55 | 2.73 | Every 7 years | 0.58 | 3.86 |
100% higher | -0.69 | 2.59 | Opportunity cost per day (US$1.2) | ||
Change in number of customers in presumptive arm | US$0.4 | 0.55 | 3.26 | ||
40% lower | -1.23 | 2.05 | US$0.8 | 0.55 | 3.54 |
40% higher | 1.32 | 4.60 | US$1.6 | 0.55 | 4.11 |
80% higher | 1.74 | 5.02 | US$2.0 | 0.55 | 4.39 |
100% higher | 1.89 | 5.17 | US$2.5 | 0.55 | 4.75 |
& Actual parameter value observed in the trial [24] is shown in parenthesis.