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Cost-effectiveness ...
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
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- Akpan, Edifofon (author)
- Univ Melbourne, Ctr Hlth Policy, Melbourne Sch Populat & Global Hlth, Parkville, Vic, Australia.
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- Hossain, Sheikh Jamal (author)
- Uppsala 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.
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- Devine, Angela (author)
- Univ 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.
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- Braat, Sabine (author)
- Univ 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.
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- Hasan, Mohammed, I (author)
- Bangladesh Icddr B, Maternal & Child Hlth Div, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh.
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- Tipu, S. M. Mulk Uddin (author)
- Bangladesh Icddr B, Maternal & Child Hlth Div, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh.
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- Bhuiyan, Mohammad Saiful Alam (author)
- Bangladesh Icddr B, Maternal & Child Hlth Div, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh.
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- Hamadani, Jena D. (author)
- Bangladesh Icddr B, Maternal & Child Hlth Div, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh.
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- Biggs, Beverley-Ann (author)
- Univ Melbourne, Dept Med Peter Doherty Inst, Parkville, Vic, Australia.
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- Pasricha, Sant-Rayn (author)
- Walter & 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.
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- Carvalho, Natalie (author)
- Univ Melbourne, Ctr Hlth Policy, Melbourne Sch Populat & Global Hlth, Parkville, Vic, Australia.
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Univ Melbourne, Ctr Hlth Policy, Melbourne Sch Populat & Global Hlth, Parkville, Vic, Australia Internationell barnhälsa och nutrition (creator_code:org_t)
- OXFORD UNIV PRESS, 2022
- 2022
- English.
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In: American Journal of Clinical Nutrition. - : OXFORD UNIV PRESS. - 0002-9165 .- 1938-3207. ; 116:5, s. 1303-1313
- Related links:
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Abstract
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- 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
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Näringslära (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nutrition and Dietetics (hsv//eng)
Keyword
- iron supplements
- micronutrient powders
- cost-effectiveness
- anemia
- trial
- children
- low- and middle-income country
Publication and Content Type
- ref (subject category)
- art (subject category)
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Akpan, Edifofon
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Hossain, Sheikh ...
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Devine, Angela
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Braat, Sabine
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Hasan, Mohammed, ...
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Tipu, S. M. Mulk ...
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Bhuiyan, Mohamma ...
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Hamadani, Jena D ...
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Biggs, Beverley- ...
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Pasricha, Sant-R ...
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Carvalho, Natali ...
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Uppsala University