Cost-effectiveness of CRAG-LFA screening for cryptococcal meningitis among people living with HIV in Uganda

BMC Infectious Diseases

Table 2 Costs, Effects, and ICER values of implementing universal CRAG screening

Intervention	Total Cost (95% UR)^a,c	Incremental Cost^c	DALYs	Incremental Effectiveness (DALYs averted)	ICER (cost per DALY averted)^c
No screening	9.24 (7.31to 18.40)	REFERENCE	8.55 (6.70 to 10.90)	REFERENCE	REFERENCE
CRAG screening^b	10.76 (8.39 to 12.29)	1.52 (−5.46 to 9.42)	8.30 (6.41to 10.79)	25 DALYs averted per 100 participants (13 to 47)	6.14 (−20.32 to 36.47)

Abbreviations: CP current practice, CRAG-LFA cryptococcal antigen lateral flow assay, DALY disability adjusted life-year, ICER incremental cost-effectiveness ratio
^aTotal costs represent total health systems costs, inclusive of diagnostic testing and treatment costs related to diagnosed cryptococcal antigenemia and/or cryptococcal meningitis over a 5 year time period, but excludes lifetime ART costs. DALYs were evaluated over a lifelong time horizon. Future years are discounted by 3% and ART costs are not included in base case analysis
^bThe CRAG-LFA intervention consists of screening all cohort patients for cryptococcal antigenemia with CRAG-LFA, followed by cryptococcal pre-emptive therapy (CPET) for those who screen positive
^cIn secondary analysis, the total costs inclusive of lifetime ART costs were $5772 and $5991 (incremental of139.48) for CP and CRAG-LFA screening arms, respectively. The ICER inclusive of lifetime ART costs was 558 per DALY averted

ISSN: 1471-2334