Table 4.
Base‐case cost‐effectiveness results
| CD4 <200 cells/mm3 | Costs (US$) | QALY (max 0.923) | LY (max 0.923) | Incremental net health benefit (probability of being cost‐effective), QALY | Incremental cost‐effectiveness ratios | ||
|---|---|---|---|---|---|---|---|
| K = $100 | K = $300 | K = $500 | Cost per QALY | ||||
| Strategy‐1: SP | $122.84 | 0.81015 | 0.85028 | – (0.835) | – (0.217) | – (0.077) | – |
| Strategy‐3: SPplusF | $125.11 | 0.81408 | 0.85409 | −0.01881 (0) | −0.00366 (0) | −0.00062 (0.001) | Ext dominated |
| Strategy‐2: EP | $126.10 | 0.83095 | 0.86451 | −0.01186 (0.165) | 0.00991 (0.783) | 0.01426 (0.922) | $157.01 |
| Strategy‐6: CrAg SPplusF+ve SP−ve | $128.49 | 0.81319 | 0.85323 | −0.05346 (0) | −0.0158 (0) | −0.00826 (0) | Dominated |
| Strategy‐4: CrAg EP+ve SP−ve | $128.58 | 0.81438 | 0.85405 | −0.05324 (0) | −0.01493 (0) | −0.00727 (0) | Dominated |
| Strategy‐5: CrAg EP+ve EPlessF−ve | $129.28 | 0.83004 | 0.86363 | −0.04451 (0) | −0.00158 (0) | 0.00701 (0) | Dominated |
| CD4 <100 cells/mm3 | |||||||
| Strategy‐1: SP | $122.83 | 0.78407 | 0.81875 | – (0.677) | – (0.021) | – (0.005) | – |
| Strategy‐3: SPplusF | $124.94 | 0.79120 | 0.82568 | −0.01396 (0) | 0.0001 (0.001) | 0.00292 (0.002) | Ext dominated |
| Strategy‐2: EP | $126.13 | 0.81339 | 0.84140 | −0.00368 (0.322) | 0.01832 (0.979) | 0.02272 (0.993) | $112.53 |
| Strategy‐6: CrAg SPplusF+ve SP−ve | $128.40 | 0.78974 | 0.82427 | −0.05007 (0) | −0.01291 (0) | −0.00548 (0) | Dominated |
| Strategy‐4: CrAg EP+ve SP−ve | $128.56 | 0.79177 | 0.82573 | −0.04959 (0) | −0.01139 (0) | −0.00376 (0) | Dominated |
| Strategy‐5: CrAg EP+ve EPlessF−ve | $129.39 | 0.81188 | 0.83994 | −0.03781 (0) | 0.00593 (0) | 0.01468 (0) | Dominated |
| All individuals with HIV a | |||||||
| Strategy‐1: SP | $44.93 | 0.88708 | 0.90027 | – | – | – | – |
| Strategy‐3: SPplusF | $47.41 | 0.88821 | 0.90137 | −0.02369 | −0.00714 | −0.00383 | Ext dominated |
| Strategy‐2: EP | $49.65 | 0.89361 | 0.90464 | −0.04067 | −0.00920 | −0.00291 | $722.27 |
| Strategy‐6: CrAg SPplusF+ve SP−ve | $50.58 | 0.88799 | 0.90116 | −0.05558 | −0.01792 | −0.01038 | Dominated |
| Strategy‐4: CrAg EP+ve SP−ve | $50.61 | 0.88838 | 0.90143 | −0.05552 | −0.01764 | −0.01006 | Dominated |
| Strategy‐5: CrAg EP+ve EPlessF−ve | $52.75 | 0.89339 | 0.90443 | −0.07191 | −0.01976 | −0.00933 | Dominated |
CrAg, cryptococcal antigen; EP, enhanced‐prophylaxis; EPlessF, enhanced‐prophylaxis less fluconazole; Ext dominated, extendedly dominated; K, cost‐effectiveness threshold; LY, life years; QALY, quality adjusted life years; SP, standard‐prophylaxis; SPplusF, standard‐prophylaxis plus fluconazole.
a
In patients with CD4 >200 cell/mm3, only costs of the prophylaxis and CrAg testing are included.