Evaluating the Cost-Effectiveness of Triple-Drug versus Dual-Drug Therapy for Elimination of Lymphatic Filariasis in India
Author(s)
Kaviya J, MSc Health Economics1, Vanjavakam Sahithya, MPH1, Anisha M. John, MSc2, ABDUL KHADER MOINUDEEN SYED, MPH1, Kavita Kachroo, MBA, MHA1;
1Kalam Institute of Health Technology, Visakhapatnam, India, 2Kalam Institute of Health Technology ( KIHT), Visakhapatnam, India
1Kalam Institute of Health Technology, Visakhapatnam, India, 2Kalam Institute of Health Technology ( KIHT), Visakhapatnam, India
OBJECTIVES: To assess the cost-effectiveness of implementing the triple-drug regimen (IDA:
Ivermectin, Diethylcarbamazine, and Albendazole) compared to the dual-drug
regimen (DA: Diethylcarbamazine and Albendazole) in Mass Drug Administration
(MDA) programs for lymphatic filariasis (LF) elimination in India, to inform
policy decisions and optimize resource allocation for LF elimination.
METHODS: A cost-effectiveness analysis (CEA) was conducted to compare the health system
costs and Disability-Adjusted Life Years (DALYs) averted for IDA and DA. Data
on costs and DALYs averted were obtained from secondary literature. The
Incremental Cost-Effectiveness Ratio (ICER) and Net Monetary Benefit (NMB) were calculated, with the cost-effectiveness threshold (CET) set at India’s GDP per capita (US$ 2424) (2023). The ICER was estimated using the formula: ICER = (Total Cost of IDA- Total Cost of DA) / (DALYs Averted through IDA - DALYs Averted through DA). For the ICER calculation, we considered a cohort of 100,000 individuals. Sensitivity and budget impact analyses were also performed.
RESULTS: The CEA indicated that the IDA incurred total costs of $7,173 (₹595,407), while the DA costs totaled to $6,595 (₹547,407). IDA averted 132 DALYs compared to 98 DALYs by DA. The incremental cost of IDA was $578 (₹48,000) and 34 additional DALYs averted, resulting in an ICER of $17 (₹1413) per DALY averted. The incremental NMB was $81,726 (₹67,83,320). At the given CET, IDA has a 95% probability of being cost-effective. Shifting from DA to IDA would result in budgetary savings of $6.91 million (₹555 crore), representing a 46% cost reduction.
CONCLUSIONS: The findings demonstrate that IDA is cost-effective compared to DA, offering
superior health outcomes and long-term cost savings despite higher initial
cost. This supports the broader adoption of IDA in MDA programs for LF
elimination in India, contributing to efficient resource use and advancing the India's goal of LF elimination by 2030.
Ivermectin, Diethylcarbamazine, and Albendazole) compared to the dual-drug
regimen (DA: Diethylcarbamazine and Albendazole) in Mass Drug Administration
(MDA) programs for lymphatic filariasis (LF) elimination in India, to inform
policy decisions and optimize resource allocation for LF elimination.
METHODS: A cost-effectiveness analysis (CEA) was conducted to compare the health system
costs and Disability-Adjusted Life Years (DALYs) averted for IDA and DA. Data
on costs and DALYs averted were obtained from secondary literature. The
Incremental Cost-Effectiveness Ratio (ICER) and Net Monetary Benefit (NMB) were calculated, with the cost-effectiveness threshold (CET) set at India’s GDP per capita (US$ 2424) (2023). The ICER was estimated using the formula: ICER = (Total Cost of IDA- Total Cost of DA) / (DALYs Averted through IDA - DALYs Averted through DA). For the ICER calculation, we considered a cohort of 100,000 individuals. Sensitivity and budget impact analyses were also performed.
RESULTS: The CEA indicated that the IDA incurred total costs of $7,173 (₹595,407), while the DA costs totaled to $6,595 (₹547,407). IDA averted 132 DALYs compared to 98 DALYs by DA. The incremental cost of IDA was $578 (₹48,000) and 34 additional DALYs averted, resulting in an ICER of $17 (₹1413) per DALY averted. The incremental NMB was $81,726 (₹67,83,320). At the given CET, IDA has a 95% probability of being cost-effective. Shifting from DA to IDA would result in budgetary savings of $6.91 million (₹555 crore), representing a 46% cost reduction.
CONCLUSIONS: The findings demonstrate that IDA is cost-effective compared to DA, offering
superior health outcomes and long-term cost savings despite higher initial
cost. This supports the broader adoption of IDA in MDA programs for LF
elimination in India, contributing to efficient resource use and advancing the India's goal of LF elimination by 2030.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE433
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
No Additional Disease & Conditions/Specialized Treatment Areas