Sensitivity analysis

We explored the impact of individual parameter uncertainty on cost-effectiveness, in terms of both ICERs and net monetary benefit (NMB), using deterministic sensitivity analysis. NMB is expressed as the incremental value of health benefits in monetary terms (calculated by multiplying DALYs averted by the value of such benefits at the appropriate cost-effectiveness threshold), minus the incremental costs of the intervention.⁵¹

We also conducted probabilistic sensitivity analysis (PSA) to ascertain the combined impact of parameter uncertainty on incremental cost-effectiveness. Probability distributions were assigned to relevant parameters, including beta distributions for binomial probabilities, Dirichlet distributions for multinomial probabilities, and gamma distributions for costs.⁵¹ Using Monte Carlo simulation, 10 000 samples were drawn from the parameter distributions to generate incremental cost and incremental DALYs averted at both 5% and 50% PfPR.