Health economic evaluation of moist wound care in chronic cutaneous leishmaniasis ulcers in Afghanistan

Table 1 Cost and effectiveness with baseline parameters

	Health states					Av. Total
	Non-compliant	Primary closure	No primary closure	Final closure	No final closure	Av. Total
Probability of health states
WHO EMRO protocol^a	0.39	0.48	0.03	0.08	0.03	1.00
Group I	0.39	0.48	0.03	0.08	0.03	1.00
Group II	0.28	0.62	0.01	0.06	0.03	1.00
Group III	0.26	0.51	0.01	0.06	0.16	1.00
Direct medical cost
Group I (US$)	0.87	3.48	3.48	4.93	4.93	2.63
Group II (US$)	0.81	3.26	28.31	6.26	23.40	3.58
Group III (US$)	1.05	4.21	28.14	8.02	24.53	7.09
Injections/dressings
WHO EMRO^a (N =)	2	8	8	13	13	6
Group I (N =)	3	12	12	17	17	9
Group II (N =)	3	11	101	21	72	12
Group III (N =)	4	15	101	28	73	23
Drug cost
WHO EMRO^a (US$)	1.32	5.28	5.28	8.58	8.58	4.11
Group I (US$)	0.40	1.58	1.58	2.24	2.24	1.20
Group II (US$)	0.47	1.87	17.17	3.57	12.24	2.03
Group III (US$)	0.64	2.55	17.17	4.76	12.41	3.90
Direct non-medical cost
Group I (US$)	1.36	7.70	7.70	9.97	9.97	5.50
Group II (US$)	1.88	10.26	69.22	17.57	49.59	10.05
Group III (US$)	2.23	11.29	60.12	19.35	43.47	15.02
Indirect cost
Group I (US$)	5.82	1.32	5.82	1.61	5.29	3.31
Group II (US$)	5.82	0.63	5.82	1.64	4.80	2.32
Group III (US$)	5.82	0.86	5.82	1.61	5.07	2.90
Total average cost
Group I (US$)	8.05	12.50	17.00	16.51	20.19	11.43
Group II (US$)	8.51	14.15	103.35	25.47	77.79	15.91
Group III (US$)	9.10	16.36	94.08	28.98	73.07	24.97
Wound free days
Group I (WFD)	0	234	0	207	0	129
Group II (WFD)	0	270	0	167	0	177
Group III (WFD)	0	258	0	233	0	147
ICER
Group I (US$/WFD)	N.A.	0.00	N.A.	0.00	N.A.	0.00
Group II (US$/WFD)	N.A.	0.05	N.A.	−0.22	N.A.	0.09
Group III (US$/WFD)	N.A.	0.16	N.A.	0.48	N.A.	0.77
NMB (WTP = 1.92)
Group I (US$)	−8	437	−17	381	−20	236
Group II (US$)	−9	504	− 103	295	− 78	324
Group III (US$)	−9	479	−94	418	−73	257

All costs in 2013 US$
^a WHO EMRO protocol is defined as 1 to 5 ml IL SSG, twice weekly for three to 4 weeks [4]. The probability of health states of Group I was also assumed for the IL SSG WHO EMRO protocol, as a best guess. We assumed a mean IL SSG dosage of 3 ml per injection and 5 additional injections for final closure based on the IL SSG re-ulceration time found in Stahl et al. [3]

ISSN: 2049-9957