Table 4 Sensitivity of CEA results to parameter alterations

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