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Published on: March 16, 2019
An economic evaluation of implementing a decentralized dengue screening intervention under the National Vector Borne
Malaisamy Muniyandi1, Nagarajan Karikalan1, Karunya Ravi1
1Scientist-D & Head, Department of Health Economics, ICMR-National Institute for Research in Tuberculosis, No. 1, Sathyamoorthy Road, Chetpet, Chennai 60003, India.
Background:
Lack of effective early screening is a major obstacle for reducing the fatality rate and disease burden of dengue. In light of this, the government of Tamil Nadu has adopted a decentralized dengue screening strategy at the primary healthcare (PHC) facilities using blood platelet count. Our objective was to determine the cost-effectiveness of a decentralized screening strategy for dengue at PHC facilities compared with the current strategy at the tertiary health facility (THC) level.
Methods:
Decision tree analysis followed a hypothetical cohort of 1000 suspected dengue cases entering the model. The cost-effectiveness analysis was performed at a 3% discount rate for the proposed and current strategy. The outcomes are expressed in incremental cost-effectiveness ratios (ICERs) per quality-adjusted life years gained. One-way sensitivity analysis and probabilistic sensitivity analysis were done to check the uncertainty in the outcome.
Results:
The proposed strategy was found to be cost-saving and ICER was estimated to be -41 197. PSA showed that the proposed strategy had a 0.84 probability of being an economically dominant strategy.
Conclusions:
The proposed strategy is cost-saving, however, it is recommended to consider optimal population coverage, costs to economic human resources and collateral benefits of equipment.
