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Table 1 Model input parameters

From: Cost-effectiveness analysis of flucytosine as induction therapy in the treatment of cryptococcal meningitis in HIV-infected adults in South Africa

Parameter

Value

Reference

Mortality rates

% (95% CI)

 

Mortality rates at 2 weeks

 

[9]

 1-week AmBd/5FC

11.6 (5.7–17.5)

 

 1-week AmBd/Flu

32.4 (23.7–41.1)

 

 2-week AmBd/5FC

20.9 (13.4–28.3)

 

 2-week AmBd/Flu (SC)

21.9 (14.3–29.5)

 

 Oral 5FC/Flu

18.2 (13.2–23.3)

 

Mortality rates at 10 weeks

 

[9]

 1-week AmBd/5FC

23.9 (16.2–32.1)

 

 1-week AmBd/Flu

48.6 (39.4–57.9)

 

 2-week AmBd/5FC

38.3 (29.4–47.2)

 

 2-week AmBd/Flu (SC)

41.2 (32.3–50.4)

 

 Oral 5FC/Flu

35.1 (28.9–41.3)

 

Mortality rates at 6 months

 

[12]

 1-week AmBd/5FC

27.5 (16.3–44.1)

 

 1-week AmBd/Flu

55.6 (40.4–72.0)

 

 2-week AmBd/5FC

45.9 (31.6–63.1)

 

 2-week AmBd/Flu (SC)

47.2 (32.6–64.5)

 

 Oral 5FC/Flu

36.0 (26.3–47.9)

 

Mortality rates at 12 months

 

[12]

 1-week AmBd/5FC

27.5 (16.3–44.1)

 

 1-week AmBd/Flu

61.1 (45.8–76.7)

 

 2-week AmBd/5FC

45.9 (31.6–63.1)

 

 2-week AmBd/Flu (SC)

50.0 (35.1–67.1)

 

 Oral 5FC/Flu

44.0 (33.7–55.9)

 

Parameter

Basecase (range)

 

Mortality rate per annum (year 2 onwards)

0.65% (0.57–0.72)

[15]

Utilities

 Well with HIV

0.95 (0.8–0.98)

[16] (a)

 Ill with CM (induction)

0.5 (0.43–0.58)

[16] (a)

 Well with CM (maintenance)

0.8 (0.68–0.92)

[16] (a)

Length of stay (LOS) (days)

17 (7–10)

[9] (b)

Patient weight (kg)

60 (45–75)

(c)

Medicine costs (per dose)

USD

 

 Amphotericin B Deoxycholate (50 mg)

0.63

[17]

 Fluconazole (200 mg)

0.13

[17]

 Flucytosine (500 mg)

34.02

(d)

 Saline 0.9% 1 l

0.62

[17]

 Potassium chloride inj (15% in 10 ml)

0.13

[17]

 Potassium tablets 600 mg

0.08

[17]

 Magnesium tablets 250 mg

0.02

[17]

 Flucloxacillin (50 mg)

0.04

[17]

 Ceftriaxone 1 g vial

0.44

[17]

 Ampicillin 500 mg vial

12.14

[17]

 Ciprofloxacin 400 mg vial

2.76

[17]

ART first line total cost per year

251

[18]

Infusion fee per day

15.25 (0–113.6)

[19] (e)

Hospital cost per day

85.06 (73.41–189.39)

[19] (f)

Laboratory monitoring

 Serum potassium

2.17

[20]

 Serum creatinine

2.17

[20]

 Serum magnesium

2.17

[20]

 Haemoglobin

4.38

[20]

 Full blood count

4.14

[20]

 Blood draw

2.79

[20]

Lumbar puncture

 Diagnostic

60.75

[20, 19]

 Therapeutic

46.02

[20, 19]

 Blood transfusion

170

[21]

Discount rate

5% (0–10%)

[14]

  1. (a) Assumption of ±15% of basecase
  2. (b) Assumption of 1 week and 10 days LOS
  3. (c) Personal communication from Adult Level Essential Medicines List Committee
  4. (d) Personal communication on buy-out price in Western Cape
  5. (e) From no cost for infusion fee to cost in private sector facility
  6. (f) Cost of Level 2 public sector facility to cost in private sector general ward facility