Costs associated with cryptococcal meningitis diagnosis, treatment and a cryptococcal screening program in Vietnam, in US dollars.

*<p>Inclusive of: CSF culture, cell count, glucose, protein, India Ink, and LFA.</p

Sensitivity analysis: variation in cost/LYG through screening by varied testing and drug costs, positive symptoms screen, LP rate, CM mortality rate and discount rate.

<p>Sensitivity analysis: variation in cost/LYG through screening by varied testing and drug costs, positive symptoms screen, LP rate, CM mortality rate and discount rate.</p

Number Needed to Screen (NNS), by prevalence of serum CrAg-positive persons in Vietnam.

<p>Number Needed to Screen (NNS), by prevalence of serum CrAg-positive persons in Vietnam.</p

Cost-effectiveness of cryptococcal screening at a range of prevalences and cost scenarios.

<p>This graph has prevalence of asymptomatic cryptococcal antigenemia on the x-axis and incremental cost-effectiveness ratio (ICER) (increased cost per life-year gained [LYG] in US dollars) on the y-axis. The blue line represents the cost curve of full-cost fluconazole for one year of treatment. The red line represents the cost curve of full-cost fluconazole for ten weeks of treatment; the green line represents the cost curve of if fluconazole is obtained at no-cost. For Vietnam, the World Health Organization considers any intervention with an ICER under $6,948 to be ‘highly cost-effective’. This graph shows that cryptococcal screening, at any prevalence and under each of the three cost scenarios, should be considered a highly cost-effective intervention in Vietnam.</p

CrAg-positive prevalence by CD4 count and region of Vietnam.

<p>CrAg-positive prevalence by CD4 count and region of Vietnam.</p

Assumptions of a cost-effectiveness model for cryptococcal screening in Vietnam.

*<p>Dr. Cao Thuy, physician.</p>**<p>Assumed to be slightly lower than mortality among CM patients under existing standard of care, due to earlier diagnosis and treatment.</p>***<p>Assumed to be slightly higher than mortality among serum CrAg-negative patients under a screening scenario.</p