Fig 1.
Decision analytic model for drug sampling at pharmacy (A Medicines Model) and malarial illness (B Patients Model).
Table 1.
Probability with which each device will identify genuine, substandard (between 50% and 80% API) and falsified (wrong/0% API) medicines with strategies of 1/2/3 samples per brand of ACTs.
Table 2.
List of parameters used in the cost-effectiveness analysis model.
Table 3.
Fixed and variable costs of the devices.
Table 4.
Cost of implementation at country level with two prevalence scenarios.
Fig 2.
Cost of introducing post-market surveillance at country level by cost category under (A) Cost of introduction by component under a high prevalence scenario, (B) Cost of introduction by component excluding procurement costs under a high prevalence scenario, (C) Cost of introduction by component under the lower prevalence scenario, (D) Cost of introduction by component excluding procurement costs under the lower prevalence scenario.
Fig 3.
Incremental costs and effects of inspection with a 1-sample strategy in (A) high prevalence scenario; 20% substandard and 20% falsified and in (B) lower prevalence scenario; substandard 10% and falsified 5%, compared with visual inspection. The diagonal line represents the Willingness to pay threshold at US$ 2,353, Lao PDR GDP per capita).
Table 5.
Country level costs and effects in high and lower prevalence scenario per device with a 1-sample strategy compared with visual inspection ranked by descending net monetary benefit (NMB, US$).
DALYs—disability adjusted life years. ICER—incremental cost-effectiveness ratio.
Fig 4.
Incremental costs and effects of all sampling strategies (1, 2, or 3-samples per drug per inspection) under (A) high prevalence scenario and (B) lower prevalence scenario. The diagonal line represents the Willingness to pay threshold at US$ 2,353, Lao PDR GDP per capita.
Table 6.
Country level costs and effects in high and lower prevalence scenario per device and per different sample strategy compared with visual inspection ranked by descending net monetary benefits (NMB, US$).
DALY—disability adjusted life year. ICER—incremental cost-effectiveness ratio.
Fig 5.
Tornado diagram illustrating one-way sensitivity analyses with a range of plausible parameter values for key model parameters, in a lower prevalence scenario for the NIR-S-G1 device (blue bars represents scenarios with lower parameter estimates, orange bars represent scenarios with the higher parameter estimates, and dotted vertical line represents the cost-effectiveness threshold).
Table 7.
Country level costs and effects in sensitivity analysis when using one device per province instead of one per district per device in lower prevalence scenario with a 1-sample strategy compared with visual inspection in descending order of net monetary benefit (NMB, US$).
DALY—disability adjusted life year. ICER—incremental cost-effectiveness ratio.
Table 8.
Budget impact analysis under high and low prevalence scenario with a 1-sample strategy across all 42 districts.