8.2 Supplemental tables
Micro-costing parameters | Value (range); distribution | Source |
Costs | ||
Additional inpatient day | 60 (40–80); PERT | Estimated |
Liver function test | 13 (11–15); PERT | Estimated |
International normalized ratio test | 7.7 (6.3–9); PERT | Estimated |
Full blood count | 6.4 (5.5–7.3); PERT | Estimated |
Blood urea nitrogen, creatinine, & electrolytes | 11.5 (10–13); PERT | Estimated |
Alpha fetoprotein | 11.5 (11–12); PERT | Estimated |
Brief outpatient visit | 6 (4–8); PERT | Estimated |
Extensive outpatient visit | 12 (8–16); PERT | Estimated |
Abdominal ultrasonography | 10 (8–12); PERT | Estimated |
Endoscopy with band ligation | 272 (245–350); PERT | Estimated |
Spironolactone | 350 (182–782); PERT | Estimated |
Furosemide | 60.8 (55–66); PERT | Estimated |
Transarterial chemoembolization | 1810 (1400–2200); PERT | Estimated |
Triphasic CT scan | 173 (150–196); PERT | Estimated |
Sorafenib (9-12 tablets) | 1920 (1640–2190); PERT | Estimated |
Medication, Sepsis | 372 (300–732); PERT | Estimated |
Outpatient clinic visit, Malaria | 15 (10–20); PERT | Estimated |
RDT + Microscopy, Malaria | 3 (1–5); PERT | Estimated |
Medication, Malaria | 12 (4–20); PERT | Estimated |
Diagnosis, Syphilis | 15 (10–40); PERT | Estimated |
Treatment, Syphilis | 12 (5–20); PERT | Estimated |
Consultation and medication, FNHTR | 25 (20–30); PERT | Estimated |
HBsAg test, HBV | 3.78 (2.16–5.4); PERT | Estimated |
HBV profile test, HBV | 35.1 (21.6–48.6); PERT | Estimated |
HBV DNA test, HBV | 73.8 (72–75.6); PERT | Estimated |
AVT for non-cirrhotic patients, HBV | 326 (261–391); PERT | Estimated |
AVT with cirrhosis, HBV | 869 (326–3590); PERT | Estimated |
Ab screen and confirmation, HCV | 9 (7–13); PERT | Estimated |
RNA test, HCV | 145 (120–170); PERT | Estimated |
Genotyping, HCV | 163 (140–186); PERT | Estimated |
Antiviral medication, HCV | 650 (548–1090); PERT | Estimated |
AVT for decompensated cirrhosis, HCV | 1630 (1100–2170); PERT | Estimated |
AIDS care subclinical, HIV | 150 (600–50); PERT | Mikkelsen 2017 |
HIV care first year on AVT, HIV | 187 (149–224); PERT | Mikkelsen 2017 |
HIV care second year on AVT, HIV | 64.5 (51.6–77.4); PERT | Mikkelsen 2017 |
HIV care third year on AVT, HIV | 57 (45.6–68.4); PERT | Mikkelsen 2017 |
AIDS care first year on AVT, HIV | 585 (436–733); PERT | Estimated1 |
AIDS care second year on AVT, HIV | 330 (266–393); PERT | Estimated1 |
HIV care annual cost after third year on AVT, HIV | 46.4 (37.1–55.6); PERT | Mikkelsen 2017 |
Proportion receiving | ||
Medication, Sepsis | 90% (80%–100%); PERT | Estimated |
Additional inpatient day, Malaria | 5% (1%–9%); PERT | Estimated |
Outpatient clinic visit, Malaria | 50% (40%–60%); PERT | Estimated |
Diagnosis & treatment, Syphilis | 10% (5%–20%); PERT | Estimated |
Additional inpatient day, FNHTR | 50% (40%–60%); PERT | Estimated |
Quantity received | ||
Additional inpatient day, Sepsis | 6 (4–8); PERT | Estimated |
Additional inpatient day, Malaria | 1.5 (1–2); PERT | Estimated |
Outpatient clinic visit, Malaria | 1.2 (1–2); PERT | Estimated |
Additional inpatient day, FNHTR | 2 (1–3); PERT | Estimated |
Annual brief outpatient visits for chronic HBeAg-negative infection no AVT, HBV | 3 (2–4); PERT | Estimated |
Annual brief outpatient visits for chronic HBeAg-negative infection with AVT, HBV | 1 (0–2); PERT | Estimated |
Annual brief outpatient visits for compensated cirrhosis no AVT, HBV | 3 (2–4); PERT | Estimated |
Annual brief outpatient visits for compensated cirrhosis with AVT, HBV | 3 (2–4); PERT | Estimated |
Annual brief outpatient visits for decompensated cirrhosis no AVT, HBV | 4 (2–6); PERT | Estimated |
Annual brief outpatient visits for decompensated cirrhosis with AVT, HBV | 4 (2–6); PERT | Estimated |
Annual brief outpatient visits for acute infection with AVT, HCV | 3 (2–4); PERT | Estimated |
Annual brief outpatient visits for chronic HCV without cirrhosis no AVT, HCV | 3 (2–4); PERT | Estimated |
Annual brief outpatient visits for compensated cirrhosis no AVT, HCV | 4 (2–6); PERT | Estimated |
Annual brief outpatient visits with decompensated cirrhosis no AVT, HCV | 4 (2–6); PERT | Estimated |
1We assumed patients who initiated AVT after AIDS progression were diagnosed based on symptoms and therefore incurred additional costs for due to AIDS-related illnesses. Costs in the first year were comprised of $57.80 for baseline laboratory investigations, $40.46 in follow-up visits, $255 - $510 for investigation and treatment for AIDS-related illnesses, and $83.04 -- $124.56 for AVT. Costs in the second year were the same, except we assumed only one third as much spending on investigation and treatment for AIDS-related illnesses. | ||
Disease state | Microcosting calculation |
Sepsis | (cost × quantity) additional inpatient days +
|
Malaria | (cost × quantity × proportion) additional inpatient days +
|
FNHTR | (cost) medication and consult +
|
Syphilis | (cost × proportion) diagnosis +
|
HBV acute clinically managed | (2 × cost) HBsAg test +
|
HBV acute subclinical | 0 |
HBV no infection | 0 |
HBV immune tolerant clinically managed | (cost) extensive outpatient clinic visit +
|
HBV immune tolerant subclinical | 0 |
HBV carrier subclinical | 0 |
HBV carrier clinically managed | 0 |
HBV immune reactive on AVT | cost) extensive outpatient clinic visit +
|
HBV immune reactive subclinical | 0 |
HBV chronic HBeAg- on AVT | (cost) liver function test +
|
HBV chronic HBeAg- clinically managed | (cost) liver function test +
|
HBV chronic HBeAg- subclinical | 0 |
HBV compensated cirrhosis on AVT | (cost) liver function test +
|
HBV compensated cirrhosis subclinical | 0 |
HBV decompensated cirrhosis on AVT | (cost) liver function test +
|
HBV decompensated cirrhosis subclinical | 0 |
HBV hepatocellular carcinoma | (cost) liver function test +
|
HBV related death or other-cause death | 0 |
HCV acute subclinical | 0 |
HCV acute with AVT | (cost) Ab screen and confirmation +
|
HCV no infection | 0 |
HCV chronic subclinical | 0 |
HCV chronic with AVT | (cost) liver function test +
|
HCV chronic treatment failure | (cost) liver function test +
|
HCV compensated cirrhosis subclinical | 0 |
HCV compensated cirrhosis with AVT | (cost) liver function test +
|
HCV compensated cirrhosis treatment failure | (cost) liver function test +
|
HCV decompensated cirrhosis subclinical | 0 |
HCV decompensated cirrhosis with AVT | (cost) liver function test +
|
HCV decompensated cirrhosis treatment failure | (cost) liver function test +
|
HCV hepatocellular carcinoma | (cost) liver function test +
|
HCV related death or other-cause death | 0 |
ART initiation with AIDS (low) | ART costs + baseline labs + follow-up labs + LFT |
ART initiation with AIDS (typical) | |
ART initiation with AIDS (high) |
Annual transition probability | Value (range); distribution1 | Source | |
From | To | ||
HBV natural history | |||
Acute subclinical | Immune tolerant subclinical | 95% (90%–99%); PERT | Mafirakureva 2016 |
No infection | # | ||
Acute clinically managed | Immune tolerant clinically managed | 95% (90%–99%); PERT | Mafirakureva 2016 |
No infection | # | ||
No infection | No infection | 100% | |
Immune tolerant subclinical | Immune reactive subclinical | 10% (3%–20%); ß(5.063, 45.57) | Nayagam 2016 |
Hepatocellular carcinoma | 0.3% (0%–0.6%); ß(3.985, 1324.35) | Nayagam 2016 | |
Immune tolerant subclinical | # | ||
Immune tolerant clinically managed | Immune reactive on AVT | 10% (3%–20%); ß(5.063, 45.57) | Nayagam 2016 |
Immune tolerant clinically managed | # | ||
Carrier subclinical | Chronic HBeAG- subclinical | 2.68% (1.55%–4.71%); ß(11.173, 405.74) | Nayagam 2016 |
Hepatocellular carcinoma | 0.065% (0%–0.1%); ß(0.057, 94.89) | Nayagam 2016 | |
No infection | 1% (0.97%–2.26%); ß(17.146, 1257.65) | Nayagam 2016 | |
Carrier subclinical | # | ||
Carrier clinically managed | Chronic HBeAG- clinically managed | 2.68% (1.55%–4.71%); ß(11.173, 405.74) | Nayagam 2016 |
No infection | 1% (0.97%–2.26%); ß(17.146, 1257.65) | Nayagam 2016 | |
Carrier clinically managed | # | ||
Immune reactive subclinical | Chronic HBeAG- subclinical | 0.5% (0%–5%); ß(0.154, 30.69) | Nayagam 2016 |
Carrier subclinical | 5.74% (4.58%–6.88%); ß(11.971, 196.76) | Nayagam 2016 | |
Hepatocellular carcinoma | 0.65% (0.27%–1%); ß(12.596, 1925.3) | Nayagam 2016 | |
Immune reactive subclinical | # | ||
Chronic HBeAG- subclinical | Compensated cirrhosis subclinical | 4% (1%–5.2%); ß(11.173, 300.92) | Nayagam 2016 |
Hepatocellular carcinoma | 0.616% (0.27%–1%); ß(11.3, 1824.5) | Nayagam 2016 | |
Chronic HBeAG- subclinical | # | ||
Chronic HBeAG- clinically managed | Compensated cirrhosis on AVT | 4% (1%–5.2%); ß(11.173, 300.92) | Nayagam 2016 |
Hepatocellular carcinoma | 0.616% (0.27%–1%); ß(11.3, 1824.5) | Nayagam 2016 | |
Chronic HBeAG- clinically managed | # | ||
Compensated cirrhosis subclinical | Decompensated cirrhosis subclinical | 3.9% (3.2%–4.6%); ß(2.848, 70.18) | Nayagam 2016 |
Hepatocellular carcinoma | 3.66% (0.8%–8%); ß(3.947, 103.88) | Nayagam 2016 | |
HBV-related death | 3.9% (3.9%–50.7%); ß(0.27, 6.66) | Nayagam 2016 | |
Compensated cirrhosis subclinical | # | ||
Decompensated cirrhosis subclinical | Hepatocellular carcinoma | 3.76% (2.3%–7.1%); ß(9.411, 240.88) | Nayagam 2016 |
HBV-related death | 31.4% (4.3%–57%); ß(3.583, 7.83) | Nayagam 2016 | |
Decompensated cirrhosis subclinical | # | ||
Hepatocellular carcinoma | HBV-related death | 50% (40%–100%); ß(5.056, 5.06) | Nayagam 2016 |
Hepatocellular carcinoma | # | ||
HBV-related death | HBV-related death | 100% | Nayagam 2016 |
HBV treatment effectiveness | |||
Immune reactive on AVT | Immune reactive on AVT | 100% | Nayagam 2016 |
Chronic HBeAG- on AVT | Chronic HBeAG- on AVT | 100% | Nayagam 2016 |
Compensated cirrhosis on AVT | Hepatocellular carcinoma | 0.5% (0%–1%); ß(0.747, 149) | Nayagam 2016 |
Compensated cirrhosis on AVT | # | ||
Decompensated cirrhosis on AVT | Hepatocellular carcinoma | 1% (0%–4.4%); ß(0.808, 80) | Nayagam 2016 |
Decompensated cirrhosis on AVT | # | ||
HBV treatment uptake | |||
Initiation | Acute clinically managed | 10% (0%–25%); PERT | Estimated |
Acute subclinical | # | ||
Chronic HBeAG- subclinical | Chronic HBeAG- clinically managed | 5% (10%–20%); PERT | Estimated |
Chronic HBeAG- clinically managed | Chronic HBeAG- on AVT | 9% (4%–18%); PERT | Estimated |
Compensated cirrhosis subclinical | Compensated cirrhosis on AVT | 30% (10%–40%); PERT | Estimated |
Decompensated cirrhosis subclinical | Decompensated cirrhosis on AVT | 70% (50%–90%); PERT | Estimated |
HCV natural history | |||
Acute subclinical | No infection | 31% (15%–40%); PERT | Mafirakureva 2016 |
Chronic HCV subclinical | # | ||
No infection | No infection | 100% | |
Chronic HCV subclinical | Compensated cirrhosis subclinical | 1.1% (0.5%–1.8%); PERT | Fraser 2016 |
Chronic HCV subclinical | # | ||
Chronic HCV treatment failure | Compensated cirrhosis treatment failure | 1.1% (0.5%–1.8%); PERT | Fraser 2016 |
Chronic HCV treatment failure | # | ||
Compensated cirrhosis subclinical | Decompensated cirrhosis subclinical | 6.4% (3%–7%); PERT | Fraser 2016 |
Hepatocellular carcinoma | 3.6% (1.5%–4%); PERT | Fraser 2016 | |
Compensated cirrhosis subclinical | # | ||
Compensated cirrhosis treatment failure | Decompensated cirrhosis treatment failure | 6.4% (3%–7%); PERT | Fraser 2016 |
Hepatocellular carcinoma | 3.6% (1.5%–4%); PERT | Fraser 2016 | |
Compensated cirrhosis treatment failure | # | ||
Decompensated cirrhosis subclinical | Hepatocellular carcinoma | 6.8% (4.1%–9.9%); PERT | Fraser 2016 |
HCV-related death | 16.8% (12%–40%); PERT | Fraser 2016 | |
Decompensated cirrhosis subclinical | # | ||
Decompensated cirrhosis treatment failure | Hepatocellular carcinoma | 6.8% (4.1%–9.9%); PERT | Fraser 2016 |
HCV-related death | 16.8% (12%–40%); PERT | Fraser 2016 | |
Decompensated cirrhosis treatment failure | # | ||
Hepatocellular carcinoma | HCV-related death | 60.5% (30%–80%); PERT | Fraser 2016 |
Hepatocellular carcinoma | # | ||
HCV-related death | HCV-related death | 100% | Fraser 2016 |
HCV treatment effectiveness | |||
Acute on AVT | No infection* | 95% (90%–99%); PERT | Fraser 2016 |
Chronic HCV treatment failure | # | ||
Chronic HCV on AVT | No infection | 95% (90%–99%); PERT | Fraser 2016 |
Chronic HCV treatment failure | # | ||
Compensated cirrhosis on AVT | No infection | 95% (90%–99%); PERT | Fraser 2016 |
Compensated cirrhosis treatment failure | # | ||
Decompensated cirrhosis on AVT | No infection | 95% (90%–99%); PERT | Fraser 2016 |
Decompensated cirrhosis treatment failure | # | ||
HCV treatment uptake | |||
Initiation | Acute on AVT | 10% (0%–25%); PERT | Estimated |
Acute subclinical | # | ||
Chronic HCV subclinical | Chronic HCV on AVT | 10% (5%–30%); PERT | Estimated |
Compensated cirrhosis subclinical | Compensated cirrhosis on AVT | 30% (10%–40%); PERT | Estimated |
Decompensated cirrhosis subclinical | Decompensated cirrhosis on AVT | 70% (50%–90%); PERT | Estimated |
HIV natural history | |||
No ART, 1st year | No ART, 2nd year | 100% | |
No ART, 2nd year | No ART, 3+ years | 100% | |
No ART, 3+ years | AIDS (pediatric) | 4.21% (3.07%–5.62%); PERT | Morgan 2002 |
AIDS (adult) | 15% (10.1%–22.6%); PERT | Morgan 2002 | |
HIV-related death (pediatric) | 1.5% (0%–6.9%); PERT | Morgan 2002 | |
HIV-related death (adult) | 0% (0%–5.5%); PERT | Morgan 2002 | |
No ART, 3+ years | # | ||
AIDS subclinical | HIV-related death (pediatric) | 60.2% (32.4%–60.2%); PERT | Morgan 2002 |
HIV-related death (adult) | 61.5% (28.6%–64.9%); PERT | Morgan 2002 | |
AIDS subclinical | # | ||
HIV-related death | HIV-related death | 100% | Morgan 2002 |
HIV treatment uptake | |||
Initiation | ART year 1 | 7.5% (0%–15%); PERT | Estimated |
HIV subclinical year 1 | # | ||
HIV subclinical year 1 | ART year 1 | 7.1% (0%–13%); PERT | Estimated |
HIV subclinical year 2 | ART year 1 | 18.6% (7%–31%); PERT | Estimated |
HIV subclinical year 3+ | ART year 1 | 30% (14%–47%); PERT | Estimated |
AIDS subclinical | AIDS on ART year 1 | 50% (30%–70%); PERT | Estimated |
HIV treatment effectiveness | |||
ART year 1 | ART year 2 | 100% | Assumed |
ART year 2 | ART year 3 | 100% | Assumed |
ART year 3 | ART year 4+ | 100% | Assumed |
ART year 4+ | ART year 4+ | 100% | Assumed |
AIDS on ART year 1 | HIV-related death | 30% (15%–40%); PERT | Estimated |
AIDS on ART year 2 | # | ||
HIV-related death | 15% (0%–30%); PERT | Estimated | |
AIDS on ART year 2 | ART year 3 | # | |
1Transitions indicated by `#` are calculated as one minus the probability of transitioning to any other state. | |||
Disease state | Annual cost | Undiscounted Lifetime cost, Adult | Undiscounted Lifetime cost, Pediatric | Net present lifetime cost, Adult | Net present lifetime cost, Pediatric |
HBV | |||||
Acute clinically managed | $134.46 | $6.72 | $6.72 | $6.72 | $6.72 |
Acute subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Carrier clinically managed | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Carrier subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Chronic HBeAG- clinically managed | $179.30 | $89.31 | $311.25 | $40.83 | $97.49 |
Chronic HBeAG- on AVT | $493.23 | $189.04 | $1,625.93 | $75.87 | $372.47 |
Chronic HBeAG- subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Compensated cirrhosis on AVT | $1,116.34 | $435.83 | $3,222.18 | $178.72 | $769.95 |
Compensated cirrhosis subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Decompensated cirrhosis on AVT | $2,076.14 | $29.53 | $202.94 | $12.13 | $49.62 |
Decompensated cirrhosis subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
HBV-related death | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Hepatocellular carcinoma | $4,210.60 | $686.46 | $1,172.62 | $431.95 | $579.62 |
Immune reactive on AVT | $463.61 | $918.23 | $2,239.59 | $514.49 | $861.79 |
Immune reactive subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Immune tolerant clinically managed | $137.68 | $118.06 | $128.63 | $95.30 | $101.08 |
Immune tolerant subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
No infection | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Other-cause death | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
HCV | |||||
Acute on AVT | $1,154.50 | $57.72 | $57.72 | $57.72 | $57.72 |
Acute subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Chronic HCV on AVT | $1,173.40 | $500.69 | $562.66 | $385.60 | $416.95 |
Chronic HCV subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Chronic HCV treatment failure | $523.40 | $307.38 | $694.33 | $174.09 | $279.62 |
Compensated cirrhosis on AVT | $1,208.60 | $59.74 | $68.95 | $43.42 | $47.98 |
Compensated cirrhosis subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Compensated cirrhosis treatment failure | $558.60 | $32.31 | $70.99 | $17.84 | $28.63 |
Decompensated cirrhosis on AVT | $3,291.40 | $15.62 | $18.33 | $10.98 | $12.30 |
Decompensated cirrhosis subclinical | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Decompensated cirrhosis treatment failure | $1,657.40 | $12.78 | $29.56 | $6.80 | $11.44 |
HCV-related death | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Hepatocellular carcinoma | $4,210.60 | $42.65 | $72.52 | $26.82 | $35.89 |
No infection | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Other-cause death | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
HIV | |||||
AIDS on ART year 1 | $584.56 | $51.53 | $15.04 | $44.98 | $13.02 |
AIDS on ART year 2 | $329.56 | $24.63 | $7.24 | $20.88 | $6.08 |
ART year 1 | $186.70 | $153.99 | $172.12 | $142.21 | $157.71 |
ART year 2 | $64.52 | $54.47 | $61.02 | $49.00 | $54.46 |
ART year 3 | $57.02 | $51.99 | $55.10 | $45.20 | $47.68 |
ART year 4+ | $46.35 | $1,076.14 | $2,484.80 | $618.59 | $1,003.52 |
HIV-related death | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Other-cause death | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Subclinical AIDS | $150.00 | $22.57 | $6.55 | $20.30 | $5.84 |
Subclinical HIV year 1 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Subclinical HIV year 2 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Subclinical HIV year 3+ | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |