In Malaysia, the national thalassemia program checks students in two steps. The usual way, called protocol 1, asks kids to come back for more visits. About one in five drops out, especially in rural Sabah and Sarawak. A new idea, protocol 2, keeps one blood sample and runs three tests from it, so no extra trips are needed.
Researchers looked at 2018 records from 65,990 students in those two states. They ran a computer test 10,000 times, giving each cost and dropout rate a chance to vary. Costs were allowed to wiggle around with a 15% spread, and dropout chances followed a beta-binomial shape. They then asked, for each possible willingness to pay, how likely the new method would be worth it.
The average extra cost per extra carrier found matched the earlier simple calculation: about MYR 2