Figure 3.

a-c: Simulation of incremental cost-effectiveness calculations for PDMC in Malawi (750 iterations) with pairwise comparisons of the three strategies, each with a 95% confidence ellipse, and a willingness to pay-line of one GDP per capita in USD (WTP, 535 USD for Malawi, 2017): a) community-based PDMC versus standard of care; b) facility-based PDMC versus standard of care; c) community- versus facility-based PDMC.

In each of the three scatterplots, the expected average cost and effectiveness of the baseline strategy are set as zero USD and zero HALY, respectively, at the intersection of the dotted lines. Each of the 750 dots (red and green) represents the cost and effectiveness of the comparator strategy in 750 iterations. Green dots indicate that the comparator strategy was cost-effective compared to the baseline (East of the WTP) in that particular iteration. Red dots represent iterations where the baseline strategy was found cost-effective (West of the WTP). The green ellipses show the 95% confidence interval. The frequency and proportion of iterations (10·000) per quadrant and category are shown for all countries in the supplementary material (Table S10). PDMC=postdischarge malaria chemoprevention. DP=dihydroartemisinin–piperaquine. USD=United States Dollars.