Table 2.

Incremental cost-effectiveness ratios per country, comparing community-based postdischarge malaria chemoprevention (PDMC) with facility-based PDMC, and with the national standard of care.

		Cost (USDa)				Effectiveness (QALYb)		Cost-effectiveness
Country	Strategy	Health care provider cost	Household cost	Total cost	Incremental cost	HALEc	Incremental QALY	ICERd
Malawi	Standard of care	36·00	8·91	44·84		52·65		negative
	PDMC Facility-delivered	19·50	11·65	31·11	−13·72	52·98	0·33	negative
	PDMC Community-delivered	16·95	5·83	22·74	−8·37	53·03	0·05	dominant
Kenya	Standard of care	46·63	29·98	76·40		53·86		negative
	PDMC Facility-delivered	26·27	23·47	51·49	−24·91	54·20	0·34	negative
	PDMC Community-delivered	22·54	15·72	37·87	−13·61	54·25	0·05	dominant
Uganda	Standard of care	41·95	14·16	56·00		53·84		negative
	PDMC Facility-delivered	22·46	18·44	40·84	−15·16	54·18	0·34	negative
	PDMC Community-delivered	19·33	10·50	29·78	−11·07	54·23	0·05	dominant

Incremental cost-effectiveness rankings per country. This table reports mean values from Monte-Carlo simulations of 10·000 iterations per country. Confidence intervals are shown as 95% confidence interval ellipsoids in Figures 3a-c; an extended version of this table with confidence intervals of the mean values is shown in the supplementary materials, Table S9. When comparing the three strategies, Community-delivered PDMC was the absolute dominant strategy: it was at the same time the least costly over the expected lifetime of a child (lowest cost per QALY gained) and yielded the most health-adjusted life-years. The incremental quality-adjusted life years (QALY) specify each strategy's expected impact on mortality and morbidity. The incremental values indicate that the facility-based distribution also absolutely dominates the standard of care. However, it is less cost-saving and less effective than community-based distribution when compared to standard of care.

^aUSD– United States Dollar.

^bQALY– Quality-adjusted life years.

^cHALE– Health-adjusted life expectancy.

^dICER– Incremental cost-effectiveness ratio.