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


Mohsen Barouni 1 , Feysal Jamalzadeh 2 , * , Reza Goudarzi 3


1 Assistant Professor Department of Health Economics, Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran.

2 MSc of Health Economics, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

3 Assistant Professor Department of Health Economics, Research Center for Health Services Management, Kerman University of Medical Sciences, Kerman, Iran.


Hormozgan Medical Journal: 19 (3); e87457
Published Online: April 30, 2014
Article Type: Research Article
Received: October 12, 2013
Accepted: April 30, 2014




Introduction: 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.
Methods: 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 costeffectiveness
analysis and sensitivity analysis of both abovementioned methods. Sensitivity
analysis was performed for the key variables.
Results: 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 costeffectiveness
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.
Conclusion: This study demonstrated that RDT in contrast to the microscopy method is
cost-effective, if its high accuracy is maintained.


Malaria – Cost-Effectiveness - Microscopic

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