Cost-Effectiveness analysis of malaria diagnosis techniques in patients with suspected malaria in Hormozgan province- 2012

Since ancient times Malaria in Iran has been considered as a serious health risk, especially in Hormozgan Province, as no other disease like Malaria has imposed irreparable financial and life losses to the country. Since saving costs in the healthcare sector comes as first priority in most countries, this study aims at launching a cost-effectiveness analysis on malaria diagnosis diseases in the fevered patients with suspected malaria in Hormozgan Province. The target population of this study was all fevered patients with suspected malaria who have referred to the healthcare centers. All subjects whose disease was diagnosed correctly (both truly positive and truly negative) with microscopy methods and malaria rapid diagnostic tests (RDTs) were selected as the final population in this study. Decision tree analysis and Treeage2011 software were used for conducting cost-effectiveness analysis and sensitivity analysis of both abovementioned methods. Sensitivity analysis was performed for the key variables. Results of the study indicated that the total cost of the microscopy method was 18293576000.2 Rials and the total cost of RDT method was 1739980000 rials. Cost per each correct diagnosis by RDT was 17399 rials and cost per each correct diagnosis by microscopy method was 18293 rials. The total cost-effectiveness resulted from microscopy and RTD methods were 92135 and 90298 cases, respectively. The incremental cost-effectiveness ratio (ICER) for each correct diagnosis by the microscopy method in contrast to RTD method was 47052 rials. The mean cost-effectiveness ratio for RDT was 19289; whereas it was 19862 for the microscopy method. Sensitivity analysis results indicate that when sensitivity of the microscopy method for Plasmodium vivax is below 0.981, then RDT will be the cost effective method. This study demonstrated that RDT in contrast to the microscopy method is cost-effective, if its high accuracy is maintained.