Costing inputs and unit costs
| Input description | Units | Value |
| Eligible population (adult population, age 18+) | ||
| Golapganj | Persons | 261 098 |
| Fenchuganj | Persons | 86 503 |
| Beanibazar | Persons | 209 454 |
| Bishwanath | Persons | 192 075 |
| Primary healthcare attendance rate (annual) | Per cent | 47.9% |
| Adult population with risk factors | ||
| Use of tobacco products | Per cent | 43.7% |
| Hazardous or harmful use of alcohol | Per cent | 4.4% |
| Physical inactivity | Per cent | 12.3% |
| Hypertension (≥140/90 mm Hg) | Per cent | 21.0% |
| Diabetes (≥7.0 mmol/L or 126 mg/dL) | Per cent | 8.3% |
| Hyperlipidaemia (≥6 mmol/L or 190 mg/dL) | Per cent | 28.4% |
| Low CVD risk (0 to <10%) | Per cent | 85.1% |
| Medium CVD risk (10 to <20%) | Per cent | 14.4% |
| High CVD risk (≥20%) | Per cent | 0.5% |
| Annual wage (in LCU (BDT) and USD, including benefits) | ||
| Doctors | BDT (USD)/year | 1 399 452 (16 484) |
| Nurses | BDT (USD)/year | 726 360 (8555) |
| CHWs | BDT (USD)/year | 486 568 (5731) |
| Lab technicians | BDT (USD)/year | 576 720 (6793) |
| Accountant | BDT (USD)/year | 576 720 (6793) |
| Administrative assistant | BDT (USD)/year | 446 242 (5256) |
| Clerical officer | BDT (USD)/year | 446 242 (5256) |
| Custodian | BDT (USD)/year | 446 242 (5256) |
| IT personnel | BDT (USD)/year | 446 242 (5256) |
| Programme director | BDT (USD)/year | 1 399 452 (16 484) |
| Programme manager | BDT (USD)/year | 726 300 (8555) |
| Secretary | BDT (USD)/year | 446 242 (5256) |
| Security officer | BDT (USD)/year | 400 196 (4714) |
| Pharmacist/chemist | BDT (USD)/year | 576 720 (6,793) |
| Statistician | BDT (USD)/year | 576 720 (6793) |
| Supplies manager | BDT (USD)/year | 486 568 (5731) |
| Purchasing price (in LCU (BDT) and USD) of pharmaceutical drugs | ||
| Hypertension medicine | ||
| Amlodipine 5 mg | BDT (USD)/tablet | 1 (0.012) |
| Losartan 50 mg | BDT (USD)/tablet | 8 (0.094) |
| Hydrochlorothiazide | BDT (USD)/tablet | 0.35 (0.004) |
| Diabetes medicine | ||
| Metformin 500 mg | BDT (USD)/tablet | 4 (0.047) |
| Metformin 1000 mg | BDT (USD)/tablet | 9 (0.106) |
| Gliclazide | BDT (USD)/tablet | 3.5 (0.041) |
| Cholesteror medicine | ||
| Simvastatin 10 mg | BDT (USD)/tablet | 7 (0.082) |
| Atorvastatin 20 mg | BDT (USD)/tablet | 10 (0.118) |
| Atorvastatin 40 mg | BDT (USD)/tablet | 28 (0.330) |
| Purchasing price (in LCU) of diagnostic tests | ||
| Diabetes (complete blood count panel) | BDT (USD)/test | 400 (4.71) |
| Diabetes (fasting blood glucose) | BDT (USD)/test | 120 (1.41) |
| Diabetes and cholesterol (blood lipid panel) | BDT (USD)/test | 800 (9.42) |
| Counselling patients to change behaviour | ||
| Time to counsel a patient to change behaviour | Minutes | 10 |
| # of 'How to quit' informational materials disseminated per person, annually (print) | 5 | |
| Cost of 'How to quit' informational materials, per unit (print materials) | BDT (USD)/print | 20 (0.24) |
| LCU to USD exchange rate | BDT/USD | 84.9 |
| ‘Safety stock’ required to be on hand for medicines | Percent | 3.0 |
| No of health providers in need of training | ||
| Counsel patients to change behaviour | Persons | 30 |
| Assess patients' total CVD risk | Persons | 10 |
| Training to counsel patients to change behaviour (5A’s)* | ||
| Classroom size | Persons | 30 |
| Hours of training needed | Persons | 16 |
| Training to screen/diagnosis/treat patients hypertension/CVD patients | ||
| Classroom size | Persons | 30 |
| Hours of training needed | Persons | 8 |
| No of trainers | ||
| Professional trainer(s) | Persons | 2 |
| Administrative staff | Persons | 1 |
| Input costs for training | ||
| Hourly wage | ||
| Professional trainer | BDT (USD)/hour | 500 (5.89) |
| Administrative staff | BDT (USD)/hour | 250 (2.94) |
| Per unit cost of materials | ||
| Instructive handbooks | BDT (USD)/book | 1000 (11.8) |
| Facility rental for training (1 day) | BDT (USD)/day | 9000 (106) |
| Refreshments | BDT (USD)/day | 6000 (70.7) |
| Per diem for staff | BDT (USD)/day | 3500 (41.2) |
| Per diem and/or salary of trainees | BDT (USD)/day | 5000 (58.9) |
| Transportation stipend for staff | BDT (USD)/training | 3165 (37.3) |
| CVD risk screening and diagnosis | ||
| Time (in minutes) a health provider spends to: | ||
| Screen patients for total CVD risk | Minutes | 5 |
| Provide a physical exam to assess patients' total CVD risk | Minutes | 5 |
| Assess patient risk using a CVD risk chart | Minutes | 5 |
| Time (in minutes) a lab technician spends to: | ||
| Administer and analyse a blood test | Minutes | 10 |
| Administer and analyse a urine test | Minutes | 10 |
| Treatment for high CVD risk | ||
| # follow-up visits for a person annually with the following levels of CVD risk annually | ||
| Low CVD risk (≥0% to <10%) | Visits | 2 |
| Medium CVD risk (≥10% to <20%) | Visits | 3 |
| High CVD risk (≥20%) | Visits | 4 |
| Time health providers spend with a patient during a visit? | ||
| Generalists/primary care doctors | Minutes | 5 |
| Nurses | Minutes | 5 |
| Screen for CVD risk: Diagnostics cost in LCU (BDT) and USD | ||
| Diabetes (compete blood count panel) | BDT (USD)/test | 400 (4.7) |
| Diabetes (fasting blood glucose) | BDT (USD)/test | 120 (1.4) |
| Diabetes and cholesterol (blood lipid panel) | BDT (USD)/test | 80 (0.9) |
| Pharmacological treatment for hypertension | ||
| Hypertension Protocol Step #1 (Amlodipine 5 mg, 1 per day, 365 days) | ||
| % of all individuals with high blood pressure who receive this treatment regimen | Percent | 62% |
| Hypertension protocol step #2 (Amlodipine 5 mg+Losartan 50 mg) | ||
| % of all individuals with high blood pressure who receive this treatment regimen | Percent | 34% |
| Hypertension protocol step #3 (Amlodipine +Losartan+ Hydrochlorothiazide) | ||
| % of all individuals with high blood pressure who receive this treatment regimen | Percent | 4% |
| Unit price of amlodipine 5 mg in LCU (Taka or BDT) and USD | BDT (USD)/tablet | 1 (0.012) |
| Unit price of losartan 50 mg in LCU (Taka or BDT) and USD | BDT (USD)/tablet | 8 (0.094) |
| Unit price of hydrochlorothiazide in LCU (Taka or BDT) and USD | BDT (USD)/tablet | 0.35 (0.004) |
| Pharmacological treatment for diabetes | ||
| Diabetes protocol step #1 (metformin 500 mg) | ||
| % of all individuals with diabetes who receive this treatment regimen | Percent | 75% |
| Diabetes protocol step #2 (metformin 1000 mg) | ||
| % of all individuals with diabetes who receive this treatment regimen | Percent | 15% |
| Diabetes protocol step #3 (metformin 1000 mg+gliclazide 8 mg) | ||
| % of all individuals with diabetes who receive this treatment regimen | Percent | 10% |
| Unit price of metformin 500 mg in LCU (Taka or BDT) and USD | BDT (USD)/tablet | 4 (0.047) |
| Unit price of metformin 1000 mg in LCU (Taka or BDT) and USD | BDT (USD)/tablet | 9 (0.106) |
| Unit price of gliclazide 80 mg in LCU (Taka or BDT) and USD | BDT (USD)/tablet | 3.5 (0.041) |
| Pharmacological treatment for high cholesterol (default regimens) | ||
| High cholesterol protocol step #1 (low intensity, simvastatin 10 mg) | ||
| Percent of all individuals with high cholesterol who receive this treatment | Percent | 85% |
| High cholesterol protocol step #2 (moderate intensity, atorvastatin 20 mg) | ||
| Percent of all individuals with high cholesterol who receive this treatment | Percent | 10% |
| High cholesterol protocol step #3 (high intensity, atorvastatin 40 mg) | ||
| Percent of all individuals with high cholesterol who receive this treatment | Percent | 5% |
| Unit price of simvastatin 10 mg in LCU (Taka or BDT) and USD | BDT (USD)/tablet | 7 (0.082) |
| Unit price of simvastatin 20 mg in LCU (Taka or BDT) and USD | BDT (USD)/tablet | 10 (0.118) |
| Unit price of atorvastatin 40 mg in LCU (Taka or BDT) and USD | BDT (USD)/tablet | 28 (0.330) |
*The ‘5A’ model is an evidence-based approach entailing health behaviour change counselling to prevent NCD risk factors in primary care setting.25 26
5A’s, Assess, Advise, Agree, Assist, Arrange; BDT, Bangladesh Taka; CHWs, community health workers; CVD, cardiovascular disease; LCU, Local currency unit; NCD, non-communicable disease.