Table 1. Values of procedures, treatments, medications, and tests included in the economic model and other parameters of the model.
| Procedures/Drugs/Treatment (the reference is no intervention) | Costs (U$S) | |||
|---|---|---|---|---|
| Medicines | Concentration | Unit cost | Treatment cost | Source |
| Fluconazole | 150 mg | 0.07 | - | Brasil. Ministério da Saúde12 |
| Fluconazole | 100 mg | 3.14 | - | Brasil. Ministério da Saúde12 |
| Daily dosage | Duration (weeks) | Daily cost/ patient | Treatment cost | Source |
| Preemptive treatment | ||||
| Fluconazole 800 mg | 2 | 6.56 | 92.00 | Brasil. Ministério da Saúde12 |
| Fluconazole 400 mg | 8 | 3.28 | 184.00 | Brasil. Ministério da Saúde12 |
| CM treatment | ||||
| Induction phase | ||||
| Mycoses treatment (code 03.03.01.016-9) | 2 | 23.27 | 325.72 | Brasil. Ministério da Saúde13 |
| Consolidation phase | ||||
| Fluconazole 600 mg/day | 8 | 0.29 | 17.23 | Brasil. Ministério da Saúde13 |
| Maintenance phase | ||||
| Fluconazole 200 mg | 48 | 6.28 | 2,293.66 | Brasil. Ministério da Saúde12 |
| Tests and culture | Amount | Unit cost | Cost / patient | Source |
| CRAG-LFA | 1 | 6.00 | 6.00 | Brasil14 |
| CRAG-LA | ||||
| Cryptococcus research - latex (code 4.03.09.05-3) | 1 | 0.36 | 0.36 | Associação Médica Brasileira15 |
| Cryptococcus research – India ink (code 4.03.10.10-0) | 1 | 0.14 | 0.14 | Associação Médica Brasileira15 |
| Culture for fungi identification (code 02.02.08.13-7) | 1 | 0.84 | 0.84 | Brasil. Ministério da Saúde13 |
| Procedures | Amount | Unit cost | Cost / patient | Source |
| Collection of samples for laboratory examination (code 02.01.02.004-1) | 2 | 0 | 0 | Brasil. Ministério da Saúde13 |
| Specialized medical attention (code 03.01.01.007-2) | 2 | 2.00 | 4.00 | Brasil. Ministério da Saúde13 |
| Individuals with CRAG-LA test, India´s ink (LP) | ||||
| Lumbar puncture (code 02.01.01.063-1) | 1 | 1.41 | Brasil. Ministério da Saúde13 | |
| Induction phase | ||||
| Mycoses treatment (code 03.03.01.016-9) | 2 | 23.27 | 325.72 | Brasil. Ministério da Saúde13 |
| Consolidation phase | ||||
| Specialized medical attention (code 03.01.01.007-2) | 2 | 2.00 | 4.00 | Brasil. Ministério da Saúde13 |
| Maintenance phase | ||||
| CD4 Lymphocyte count (code 02.02.03.002-4) | 2 | 3.00 | 6.00 | Brasil. Ministério da Saúde13 |
| Collection of samples for laboratory examination (code 02.01.02.004-1) | 2 | 0 | 0 | Brasil. Ministério da Saúde13 |
| Specialized medical attention (code 03.01.01.007-2 -) | 3 | 2.00 | 6.00 | Brasil. Ministério da Saúde13 |
| Parameters | Probability (%) | CI (95%) | Distribution | Source |
| Percentage of CD4 ≤ 100 in cryptococcosis | 40 | 30–70 | Rajasingham et al. 17 | |
| Percentage CD4 ≤ 200 cells/mm3 in cryptococcosis | 60 | 30–70 | Rajasingham et al.17 | |
| Developed CM after preemptive treatment | 14 | Meya et al.19 | ||
| Diesd after preemptive treatment | 29.1 | Meya et al.19 | ||
| Developed CM after hospital treatment | 8 | 0–20 | Beta | Meya et al.19 |
| CRAG+ among those who developed CM | 33 | 25–41 | Beta | Rajasingham et al.17 |
| CRAG+ among those who developed MC and died | 40 | 34–46 | Beta | Rajasingham et al.17 |
| CM progression in CRAG+ without preemptive treatment | 70 | 56–82 | Beta | Rajasingham et al.17 |
| Survived after hospital treatment | 45 | 38–52 | Beta | Ramachandran et al.18 |
| Developed CM after hospital treatment | 32 | Ramachandran et al.18 | ||
| PLHIV CD4 ≤ 200 cells/mm3 CRAG+ asymptomatic with CM | 2.3 | Meya et al. 19 | ||
| PIHIV CD4 ≤ 100 cells/mm3 CRAG+ asymptomatic with CM | 8.04 | 5.8–12.6 | Beta | Morawski et al.21, Meya et al.19, |
| CM mortality (fatality ratio) | 26–63 | Vidal and Boulware8 | ||
| Utility | ||||
| Stable with HIV | 0.95 | 0.8–0.98 | Beta | Miot et al.11 |
| CM patient (induction phase) | 0.5 | 0.43–0.58 | Beta | Miot et al.11 |
| Stable with CM (maintenance phase) | 0.8 | 0.68–0.92 | Beta | Miot et al.11 |
| Cryptococcus accuracy tests | Sensitivity (%)/ CI (%) | Specificity (%)/ CI (%) | Source | |
| Serum | ||||
| CRAG-LFA | 100 (98-100) | 99 (97-99.4) | Vidal and Boulware8 | |
| CSF | ||||
| CRAG-LA | 97.1 (91.9-99.0) | 99.1 (93.8-99.9) | Temfack et al.21 | |
| India ink | 86.1 | 97.3 | Nalintya et al.22, Boulware et al.23 | |
| CSF culture | 95-100 | Consensus on cryptococcosis4 | ||
CI = confidence interval.