BasicInput

Epidemiology in Zachistan

Total population of Zachistan 34,619,949

Age-wise Breakdown of Severe Arvophillia < 3 Years 3-5 Years 5-9 Years 9-14 Years > 14 Years

Percent of severe Arvophillia cases 70% 8% 2% 6% 14%

Weight in each category (kgs) 10 16 23 38 62

Treatment Protocols Huffstatin Clairadol

Mortality

Children (<14 years age) 10.90% 8.50% Adulta (>14 years age) 22% 15%

Consumables/Patient

Syringes 10 6

Needles 10 6

Cannulas 3 1

IV Giving sets 3 1

Price List Basic Unit Pack Size Unit Cost (USD)

Huffstatin 300mg/ml Amp 1 0.16

Clairadol 60mg/ml Vial 1 1.2

IV Dextrose 5% (500ml) Bottle 1 0.5

Syringe Piece 1 0.05

Needle Piece 1 0.17

Cannula Piece 1 0.23

Giving Set Piece 1 0.17

Sheet2

Sheet3CASE INSTRUCTIONS
Dear Candidate:
This exercise consists of a case study of two treatment options for a disease called Arvophillia and
introduction of the newer treatment option in a country called Zachistan. Arvophillia, Zachistan and
any other names used in the case are fictitious. No outside sources or research is required (or need
to be used). If necessary, make assumptions and please report them distinctly.
Time Constraints:
You have 48 hours to return this case exercise to us and we recommend you spend 3 hours actively
working on it. On average people allocate their time in following way across each section:

Reading case study & collating information: 30 minutes

Quantitative analysis: 90 minutes

Presentation: 30 minutes

Memo: 30 minutes

Result Components:
Based on the details provided in the case study, kindly provide:
1. A Quantitative Analysis of the two treatments to estimate cost per life saved in Zachistan using
the new treatment option; please show all your calculations, assumptions and outcomes clearly
using Microsoft Excel; cost per life saved is defined as:
Δ $s/ Δ Lives
Δ $s : Additional dollars spent using clairadol instead of huffstatin
Δ Lives: Additional lives saved using clairadol instead of using huffstatin
The following calculations need to be performed to arrive at the final number:

Number of cases of severe arvophillia (in each age category)

Cost of drugs and other consumables (under each treatment protocol)

Total number of lives saved
This exercise is confidential and proprietary. Please do not share with others.

Extra cost per additional life saved

2. A PowerPoint Presentation from LOB aimed at the Ministry of Health, Zachistan, making a case
for a new treatment policy for arvophillia. Use the case study as well as outcomes from the
quantitative analysis to make a strong argument; kindly keep the number of slides to no more than
5. The following can be used as the broad themes for each slide:

Articulation of the problem within the context of Republic of Zachistan: 1 slide

Key background for the new treatment protocol: 1 – 2 slides

Comparative analysis of the treatment protocols and final recommendation: 1 – 2 slides

Next steps to be followed: 1 slide

3. A One-Page Memo from LOB to the Ministry of Health, Zachistan, summarizing clearly the case
for the new treatment policy. The following points need to be addressed in the memo:

The challenge: Disease profile in the country, current treatment protocol and the drawbacks
thereof

The solution: Key facts about the new treatment protocol

Justification: Persuasive arguments for updating the current treatment guidelines

Format for Final Results:
Your final result should have three components:
1. An Excel Spreadsheet that clearly shows your work.

2. A PowerPoint Deck

3. A Memo. On a separate page at the end of your memo, please share a breakdown of the aREPUBLIC OF ZACHISTAN –

INTRODUCING NEW TREATMENT GUIDELINES FOR SEVERE ARVOPHILLIA

Disease Overview

Arvophillia is an infectious disease that affects approximately 225 million people worldwide.
Almost one million people die from the disease each year, mostly children younger than five
years old. Although the vast majority of arvophillia cases occur in sub-Saharan Africa, the
disease is a public-health problem in more than 109 countries in the world, 45 of which are in
Africa.

Uncomplicated arvophillia is caused by a parasite that is transmitted to humans through
specific bug bites. With early diagnosis, followed by an effective and timely treatment, a patient
can expect a complete recovery. If left untreated, uncomplicated arvophillia, can progress to
severe arvophillia (approximately 10% of untreated cases). Without treatment, these severe
cases have a 100% mortality rate.

Current Treatment

Huffstatin has been the mainstay of arvophillia treatment since 1960s. For uncomplicated cases
of arvophillia, oral huffstatin is used. In the treatment of severe arvophillia, huffstatin is given
three times a day in a slow, rate-controlled intravenous (IV) drip that takes four hours per IV
drip since rapid injection results in potentially lethal low blood pressure (hypotension). The
drawbacks of the huffstatin treatment protocol are:
− Requires continual supervision of the infusion thus increasing the burden on health care

workers
− Necessitates continuous cardiac monitoring to watch out for huffstatin associated

hypotension
− May lead to extremely low blood sugar (hyperinsulinaemic hypoglycaemia) that can cause

brain damage and developmental delays in children.

New Treatment Option

Clairadol is a new treatment option that is now regarded as a highly effective alternative to
huffstatin. It is the most rapidly acting and potent of all the anti arvophillial drugs available. It
can be given in just four minutes through an intravenous (in the vein) injection once daily and is
therefore safer and easier to administer than huffstatin lowering the side effects usually
associated with the administration of huffstatin. Clairadol is now available from verified and
pre- approved suppliers that meet all quality standards.

Efficacy results

Two landmark clinical trials have been conducted to test the efficacy and the relative
superiority of clairadol over huffstatin. The first trial, called NEEDAN, was conducted in 2005.
This was a multi-site trial in South East Asia and was conducted primarily on adults (the study
results were not statistically significant for children). The second trial, called MENDLAK was
conducted in 2010 to further extrapolate the results from the NEEDAN study. This trial was
conducted on children living in nine different African countries. This trial defined children as
being the population below 14 years of age.

These trials were able to demonstrate with statistical cer