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Table 2 Recommendations for calculating and presenting cost results

From: Costing the distribution of insecticide-treated nets: a review of cost and cost-effectiveness studies to provide guidance on standardization of costing methodology

Viewpoint

Use societal perspective.

Sub-analyses can focus on specific perspectives such as provider, patient or Ministry of Health

Output

Clarify whether intervention delivers nets or treatment or both

Calculate net and treatment costs separately

Resource identification

Include all costs of behaviour change activities (including advertising)

Include any costs of treating LLINs in campaigns

Exclude research costs

Include relevant overheads of collaborating organizations (e.g. NGO contributions to procurement, management, etc)

Clarify what management capacity is assumed to exist and whether calculating average cost or incremental cost of adding intervention to an existing programme

Resource measurement

Attempt to measure and report leakage of resources (e.g. nets used by individuals outside target groups)

Establish average lifespan of net under local conditions

Resource valuation

Treat nets as a capital item.

Base case should assume life expectancy of 3 years and use discount rate of 3% Avoid double counting of user contributions where cost recovery applied, but ensure these are counted as user contributions when disaggregating costs by source

Sensitivity analysis

Conduct sensitivity analysis on: discount rate (0%, 5%, 10% at a minimum); frequency of net impregnation, procurement cost of net and insecticide; number of people protected per net; lifespan of net Consider impact of research where this is conducted alongside a programme on programme effectiveness (see ref 5)

Vary proportion of shared resources where distribution carried out as part of another programme/campaign

Reporting of results

Provide costs in US$ and local currency

Specify year in which costs calculated/adjusted

Report cost per ITN delivered and cost per person sleeping under a net

Discussion of results

Compare costs with per capita government health expenditure to aid assessment of affordability

Be cautious in using cost estimates to scale up, and make explicit assumptions about whether marginal cost constant, increasing or decreasing