Causal Chain Analysis And Health Economic Modelling Of Childhood Anaemia Interventions In Developing Countries An Health Technology Assessment
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Abstract
Childhood anemia creates a significant clinical and economic burden, which possess significant challenges,
newlineespecially in developing countries. HTA on anemia has been conducted across different HTA bodies.
newlineHowever, these HTAs targeted either adult patient, adults with comorbid conditions and were mostly from
newlinedeveloped countries. HTA on different interventions for childhood anemia particularly in developing
newlinecountries is lacking. We conducted a HTA of interventions for childhood anaemia in developing countries
newlineto provide evidence of the clinical and economic outcomes (i.e., efficacy, costs/benefits/drawbacks)
newlineassociated with interventions for addressing childhood anaemia (0-5 years aged) as well as to evaluate
newlinesubsequent impact on the health care system in the developing countries.
newlineThe HTA of the interventions for addressing childhood anaemia (0-5 years aged) was conducted in three
newlinesteps including SLR, existing HTA analysis from other HTA agencies, CE analysis and causal analysis.
newlineThe SLR targeted studies targeting childhood anemia in 0-5 years of age published post 2010. A CE analysis
newlineof iron supplements or MNPs was performed using the clinical trial outcomes and data from the literature.
newlineThe model included 3 health states: healthy population, anaemic and deaths due to anemia, and background
newlinemortality. Both societal and health system perspectives were considered over a time horizon of 5 years
newlineamong children 0-5 years of age. Incremental cost-effectiveness ratios (ICERs) were presented in terms of
newlinecost per disability adjusted life year (DALY) averted.
newlineIn the SLR, a total of 17 studies assessed the effect of different interventions on clinical outcomes associated
newlinewith anemia post 2010. Overall, it was found that supplementation effectively reduced anemia by multiple
newlinestudies. Besides reduction in the prevalence of IDA, the clinical outcome evaluated across these studies
newlineincluded increase in haemoglobin, growth, mental health, and cognition among the study population.
newlineOverall, iron supplementation alone or in addition