Table 4 |
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Sensitivity of CEA results to parameter alterations |
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| Parameter alterations |
Effect on ACER and ICER |
CEA conclusion |
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| Discount rate in estimating capital costs is 10% instead of 3% |
No effect as cost of both AL and SP rise by same margin |
Unchanged |
| AL costs 10% more than estimated |
ACER increases to US$8.67 ICER increases to US$4.57 |
Unchanged in terms of ACER but ICER increases by 18% |
| AL costs 15% more than estimated |
ACER increases to US$8.75 ICER to US$4.81 |
Unchanged in terms of ACER but ICER increases by nearly 20% |
| AL costs 50% more than estimated |
ACER and ICER of AL increase to US$9.29 and US$6.47 |
Unchanged in terms of ACER but ICER increases by 27% |
| Compliance of AL is lower at 65% |
ACER increases to US$9.02 ICER increases to US$4.95 |
Unchanged but ICER increases by |
| Efficacy of AL is lower at 90% |
ACER increases to US$9.17 ICER to US$5.25 |
Unchanged but ICER increases by nearly 30% |
| Efficacy of AL is lower at 80% |
ACER increases to US$10.12 ICER increases to US$7.99 |
Unchanged but ICER increases by 95% |
| Proportion of patients seeking second line treatment is 4.7% in both AL and SP |
ICER of AL is now US$3.10 |
The cost of additional successfully treated case is US$3.10 |
| Diagnosis of malaria is poor and 60% of cases treated are actually non-malaria cases
for both AL and SP |
Incremental cost will remain the same but the number of cases successfully treated
will drop. The cost per cases successfully treated rises proportionately to US$ 21.29
and US$26.62 for AL and SP respectively. ICER rises from US$4.10 to US$10.25. |
Decision still in favour of AL but the costs are much higher with ICER more-than doubling |
| Proportion of patients progressing to severe malaria is same at 4.7% for both AL and
SP |
ACER of SP decreases substantially from US$20.78 to $15.75 but still higher in relation
to AL. ICER increases from US$-11.52 to US$-0.94. |
ACER and ICER conclusions remain same |
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Chanda et al. Malaria Journal 2007 6:21 doi:10.1186/1475-2875-6-21 |
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