Table 4

Cost-effectiveness results with sensitivity analysis for key model uncertainties

Base case impactBase case+higher CS costBase case+higher CS cost and ESMK programme costPessimistic
Pessimistic impact+higher CS costPessimistic impact+higher CS cost and ESMK programme cost
Input parameters
 Population rate of emergency CS15%15%15%10%10%10%
 Emergency CS gap attributable to anaesthesia30%30%30%10%10%10%
 Incremental CS procedure cost*US$183US$366US$366US$183US$366US$366
 Programme cost multiplier1 x1 x2 x1 x1 x2 x
 Undiscounted programme costUS$1.18 mUS$1.18 mUS$2.36 mUS$1.18 mUS$1.18 mUS$2.36 m
 Undiscounted total costUS$6.43 mUS$11.68 mUS$12.85 mUS$1.65 mUS$2.12 mUS$3.30 m
 Additional emergency CS28 70428 70428 704258025802580
 Maternal lives saved316316316282828
 Fetal lives saved473647364736426426426
Incremental cost-effectiveness ratio
 Cost per LY (discounted)US$44US$79US$87US$125US$161US$251
 Percent of GDPpc per LY (discounted)2.8%5.1%5.6%8.0%10.3%16.1%
 Cost per maternal LY (discounted)US$779US$1412US$1557US$2246US$2880US$4492
 Percent of GDPpc per maternal LY (discounted)50%91%100%144%185%288%
  • *Excess cost of caesarean delivery cost above the cost of normal vaginal delivery.

  • CS, caesarean delivery procedure; ESMK, Every Second Matters-Ketamine; GDPpc, per capita gross domestic product; LY, life-year.