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  • Akpan, EdifofonUniv Melbourne, Ctr Hlth Policy, Melbourne Sch Populat & Global Hlth, Parkville, Vic, Australia. (author)

Cost-effectiveness of universal iron supplementation and iron-containing micronutrient powders for anemia among young children in rural Bangladesh : analysis of a randomized, placebo-controlled trial

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • OXFORD UNIV PRESS,2022
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-495801
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-495801URI
  • https://doi.org/10.1093/ajcn/nqac225DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background: Universal provision of iron supplements or iron-containing multiple micronutrient powders (MNPs) is widely used to prevent anemia in young children in low- and middle-income countries. The BRISC (Benefits and Risks of Iron Interventions in Children) trial compared iron supplements and MNPs with placebo in children <2 y old in rural Bangladesh. Objectives: We aimed to assess the cost-effectiveness of iron supplements or iron-containing MNPs among young children in rural Bangladesh. Methods: We did a cost-effectiveness analysis of MNPs and iron supplements using the BRISC trial outcomes and resource use data, and programmatic data from the literature. Health care costs were assessed from a health system perspective. We calculated incremental cost-effectiveness ratios (ICERs) in terms of US$ per disability-adjusted life-year (DALY) averted. To explore uncertainty, we constructed cost-effectiveness acceptability curves using bootstrapped data over a range of cost-effectiveness thresholds. One- and 2-way sensitivity analyses tested the impact of varying key parameter values on our results. Results: Provision of MNPs was estimated to avert 0.0031 (95% CI: 0.0022, 0.0041) DALYs/child, whereas iron supplements averted 0.0039 (95% CI: 0.0030, 0.0048) DALYs/child, over 1 y compared with no intervention. Incremental mean costs were $0.75 (95% CI: 0.73, 0.77) for MNPs compared with no intervention and $0.64 ($0.62, $0.67) for iron supplements compared with no intervention. Iron supplementation dominated MNPs because it was cheaper and averted more DALYs. Iron supplementation had an ICER of $1645 ($1333, $2153) per DALY averted compared with no intervention, and had a 0% probability of being the optimal strategy at cost-effectiveness thresholds of $200 (reflecting health opportunity costs in Bangladesh) and $985 [half of gross domestic product (GDP) per capita] per DALY averted. Scenario and sensitivity analyses supported the base case findings. Conclusions: These findings do not support universal iron supplementation or micronutrient powders as a cost-effective intervention for young children in rural Bangladesh.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Hossain, Sheikh JamalUppsala universitet,Internationell barnhälsa och nutrition,Bangladesh Icddr B, Maternal & Child Hlth Div, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh.;Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.(Swepub:uu)sheho716 (author)
  • Devine, AngelaUniv Melbourne, Ctr Epidemiol & Biostat, Melbourne Sch Populat & Global Hlth, Parkville, Vic, Australia.;Charles Darwin Univ, Menzies Sch Hlth Res, Div Global & Trop Hlth, Darwin, NT, Australia. (author)
  • Braat, SabineUniv Melbourne, Ctr Epidemiol & Biostat, Melbourne Sch Populat & Global Hlth, Parkville, Vic, Australia.;Walter & Eliza Hall Inst Med Res, Populat Hlth & Immun Div, Parkville, Vic, Australia.;Univ Melbourne, Dept Med Peter Doherty Inst, Parkville, Vic, Australia. (author)
  • Hasan, Mohammed, IBangladesh Icddr B, Maternal & Child Hlth Div, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh. (author)
  • Tipu, S. M. Mulk UddinBangladesh Icddr B, Maternal & Child Hlth Div, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh. (author)
  • Bhuiyan, Mohammad Saiful AlamBangladesh Icddr B, Maternal & Child Hlth Div, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh. (author)
  • Hamadani, Jena D.Bangladesh Icddr B, Maternal & Child Hlth Div, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh. (author)
  • Biggs, Beverley-AnnUniv Melbourne, Dept Med Peter Doherty Inst, Parkville, Vic, Australia. (author)
  • Pasricha, Sant-RaynWalter & Eliza Hall Inst Med Res, Populat Hlth & Immun Div, Parkville, Vic, Australia.;Royal Melbourne Hosp, Diagnost Hematol, Parkville, Vic, Australia.;Peter MacCallum Canc Ctr, Clin Hematol, Parkville, Vic, Australia.;Royal Melbourne Hosp, Parkville, Vic, Australia.;Univ Melbourne, Dept Med Biol, Parkville, Vic, Australia. (author)
  • Carvalho, NatalieUniv Melbourne, Ctr Hlth Policy, Melbourne Sch Populat & Global Hlth, Parkville, Vic, Australia. (author)
  • Univ Melbourne, Ctr Hlth Policy, Melbourne Sch Populat & Global Hlth, Parkville, Vic, Australia.Internationell barnhälsa och nutrition (creator_code:org_t)

Related titles

  • In:American Journal of Clinical Nutrition: OXFORD UNIV PRESS116:5, s. 1303-13130002-91651938-3207

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