Required to conduct psa using the decision-tree from the

Reference no: EM13369232

Required to conduct PSA using the decision-tree from the Patel case study (i.e. the rotavirus vaccination case study). Please follow the instructions below to modify your model, conduct PSA and answer the questions.

Step 1. Modify the tree model

Run the model and note your base case results. Based on a Tornado Diagram from the model, we have selected important variables for PSA. (You do not need to run the Tornado analysis). Please convert these variables to distributions. The distribution type and input parameters are reported in Table 1 below.Calculate the likeliest values. (Hint: μ = [(a + b + c)/3]

Step 2. Calculate the ICER again

After completing the new tree, report your base-case ICER in Table 2- hint: set Preference as Cost-Effectiveness, then Analysis >> Cost-Effectiveness.

Step 3. Conduct PSA and report the results. Use: 10,000 iterations with baseline: current practice & comparator: national program

a. Create an ICE scatterplot (turn in).

b. Explain your scatterplot.Which quadrant do most of your iterations fall into?What does this mean?

c. Plot the ICER distribution graph (turn in).

d. Report the ICER distribution statistics in the Table 3 below.

e. Explain your graph.

f. Plot the acceptability curves with a willingness to pay of $20,000 (turn in).

g. If the WTP in Pakistan is 6000 $/death averted, what is the probability that the national program will be cost-effective? What if the WTP is 10000 $/death averted?

h. Explain the figure in general terms.

Table 1. Variables and distributions for the PSA
Variable Name	Description	Baseline	Distribution	Min	Max	likeliest
*Epidemiology inputs*
pRVInfected	RVGE cumulative incidence for 5 years	0.663	Triangular	0.5	0.9
pDieOfRVGE	RVGE case-fatality ratio	0.006	Triangular	0.001	0.01
pEfficacy	Vaccine Efficacy	0.483	Triangular	0.223	0.661
pCurVaccineCoverage	Current rotavirus vaccine coverage	0.06	Triangular	0.01	0.1
pExpVaccineCoverage	Expected vaccine coverage (national programs)	0.85	Triangular	0.65	1
pHomeCare	Patients get home care	0.888	Triangular	0.7	1
pFormalOutpatient	Among those with formal care, the proportion of getting outpatient care	0.6875	Triangular	0.5	0.9
*Cost Inputs*
cUnitVaccine	Unit cost for the vaccine	5	Triangular	1	7.5
cHospitalization	Hospitalization cost (4-day stay)	33.4	Triangular	25.05	41.75

Table 2. PSA Results

Strategy	Cost	Incr Cost	Effectiveness	IncrEff	ICER
Current practice
National Program

Are the results the same from the model prior to your entering the distributions?

Table 3: PSA ICER results

	Mean	SD	Median	95% Confidence Intervals
				2.5%	97.5%
ICER

Reference no: EM13369232

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