|Cost-Effectiveness Tool for Evaluating Interventions to Prevent Mother-to-Child Transmission - Manual and Model (UNAIDS, 2000, 94 p.)|
Fixed costs are expenditure items that do not vary with short-term changes in the caseload. Good examples of fixed costs include rent, telecommunications and administrative expenses. They do not include the wages of personnel who provide direct services. This table provides a template for entering detailed information on the fixed cost expenditures required by the VCT program.
Influence on cost-effectiveness: Medium. Fixed costs can constitute over half the cost of running a VCT program, and VCT can be the dominant cost of an MTCT program.
Expected effort of data collection: Low-medium. This may be an area in which it possible to get a reasonable estimate fairly quickly by focusing on the large expenditure items which are likely to include rent, administrative costs and possibly vehicle fuel and maintenance. The increased precision obtained by tracking down the exact cost of low-cost items may be small.
C117 - C137. Monthly expenditures for fixed cost items. For each cost item, you are asked to enter a monthly expenditure figure and the percentage of that amount spent on the MTCT program. In the first few lines some typical cost items are supplied such as accounting, and telecommunications. You may alter these as you wish and can enter up to 11 additional items that are not currently listed. Finally, in cells C137 and D137 you may record the combined expenditures for all other items not specifically listed in the rows above. Data sources: Project expenditure reports are the best sources of information on fixed costs. If these are not available, budget documents can also be used though they are less desirable since they reflect planned rather than actual outlays.
D117 - D137. Percent of fixed costs expenditures that are for MTCT-related VCT. Throughout this cost analysis we seek to separate items that are strictly for VCT associated with MTCT prevention from other costs. In some cases this may be challenging. For example, consider the case in which VCT for MTCT is carried out at a clinic that also provides VCT in conjunction with STD services for men. It is likely that these services will be housed in the same building and share administrative staff and other fixed expenses. The problem then is to make a reasonable allocation of costs to these two distinct activities. Data sources: Project managers may have a good sense of how staff time and other resources are allocated among activities and in some cases the information that they are able to provide will be sufficient. In other cases it will be worthwhile to undertake a more formal accounting either by observing how staff and equipment is used (time and motion studies) or by interviewing key staff members to learn how they allocate their time.
D143 - F143. Total annual fixed costs: Result and ranges. The blue cell E143 contains the results of the calculation of fixed costs based on the data you have provided. In cells D143 and F143 please enter low-end and high-end estimates for fixed costs. As was the case with variable costs, these ranges will be used to define the lower and upper end of the ranges used in the sensitivity analyses to examine how cost-effectiveness varies with the cost of VCT.