Switching alternatives | Incremental IM averted | Incremental Costs (US$) | ICERs for one extra unit of gain (US$) |
|---|
| | | | IM averted | LY savedb | LY savedc |
|---|
| | | NGO run CNC | Govt. run CNC | Highest cost | NGO run CNC | Govt. run CNC | Highest cost | NGO run CNC | Govt. run CNC | Highest cost | NGO run CNC | Govt. run CNC | Highest cost |
|---|
UFe60F to EMMSd | 27.3 (44.1 − 16.8) | 24,746 (66,953 − 42,207) | 21,760 (58,699 − 36,939) | 27,952 (75,817 − 47,865) | 907 (24,746/27.3) | 797 (21,760/27.3) | 1024 (27,952/27.3) | 30 (24,746/819) | 27 (21,760/819) | 34 (27,952/819) | 45 (24,746/554) | 39 (21,760/554) | 51 (27,952/554) |
UFe60F to EMMSe | | | | | | | | | | | | | |
Lower limit | 36.14 (44.1 − 7.96) | 24,746 (66,953 − 42,207) | 21,760 (58,699 − 36,939) | 27,952 (75,817 − 47,865) | 685 (24,746/36.14) | 602 (21,760/36.14) | 774 (27,952/36.14) | 23 (24,746/1084) | 20 (21,760/1084) | 26 (27,952/1084) | 34 (24,746/734) | 30 (21,760/734) | 38 (27,952/734) |
Upper limit | 9.60 (44.1 − 34.50) | | | | 2577 (24,746/9.60) | 2266 (21,760/9.60) | 2911 (27,952/9.60) | 85 (24,746/288) | 76 (21,760/288) | 97 (27,952/288) | 126 (24,746/195) | 112 (21,760/195) | 143 (27,952/195) |
- a UFe60F = invitation to prenatal food at usual time in pregnancy (at about 20 week) plus 60 mg iron 400 μgm folic acid, EMMS = early invitation to prenatal food supplement (at about 9 week) plus multiple micronutrients (MMS); IM rates per 1000 live births in UFe60F 44.1, and EMMS 16.8 [reference number 15]. LY saved = IM averted* life expectancy (LE) at birth [70 years in 2012, reference number 17] discounted at 3 % and 5 %, present value 29.99 and 20.31 years, respectively. Because of rounding, some estimates are same
- b Based on LY saved when LE at birth discounted at 3 %, present value 29.99 years; moving from UFe60F to EMMS, 27.3*29.99 = 819 years
- c Based on LY saved when LE at birth discounted at 5 %, present value 20.31 years; moving from UFe60F to EMMS, 27.3*20.31 = 554 years
- d ICER for moving from UFe60F to EMMs using the point estimate HR, 0.38 (95 % CI: 0.18 to 0.78)
- e ICERs for moving from UFe60F to EMMs using the lower and upper limits of 95 % CI of HR. The lower limit of 95 % CI of HR (0.18) is related to 4.74 infant deaths [Total deaths 10 out of 595 live births; 10/0.38*0.18 = 4.74] resulting in IM rate of 7.96/1000 live births (4.74/595*1000 = 7.96); the upper limit (0.78) is related to 20.53 deaths [10/0.38*0.78 = 20.53] resulting in IM rate 34.50/1000 live births (20.53/595*1000 = 34.50). Death rates in arms EMMS, 16.8/per 1000 live births and UFe60F, 44.10/1000 live births (reference number 15). LYs saved from lower limit of HR at 3 % live expectancy at birth, 36.14*29.99 = 1084, and at 5 % discount rate of life expectancy at birth, 36.14*20.31 = 734. These figures using upper limit of HR were, 9.60*29.99 = 288, and 9.60*20.31 = 195, respectively
