Cost-effectiveness of routine versus indicated antibiotic therapy in the management of severe wasting in children

Table 2 Lifetime per-person life years, costs ($), and incremental cost-effectiveness ratios for a population size of 100,000 (7,764 total cases of severe acute malnutrition)

Strategy	Total children treated	Undiscounted life years	Incremental discounted LYS^a	Costs^a	ICER	Probability dominant strategy^b (%)	Probability optimal strategy^c (%)
19.6% program coverage for indicated and routine antibiotic therapy
Routine antibiotic therapy	1522	395,043	Reference	$1,862,478	Reference	10.8	23.9
Indicated antibiotic therapy	1522	395,480	167	$1,863,897	$8.5/LYS	37.5	76.1
25% program coverage for indicated antibiotic therapy; 19.6% coverage for routine antibiotic therapy
Routine antibiotic therapy	1522	395,043	Reference	$1,862,478	Reference	0.0	0.0
Indicated antibiotic therapy	1941	400,110	1,928	$1,887,923	$13.2 /LYS	10.2	100.0
30% program coverage for indicated antibiotic therapy; 19.6% coverage for routine antibiotic therapy
Routine antibiotic therapy	1522	395,043	Reference	$1,862,478	Reference	0.0	0.0
Indicated antibiotic therapy	2329	404,397	3,560	$1,910,169	$13.4/LYS	1.9	100.0
50% program coverage for indicated antibiotic therapy; 19.6% coverage for routine antibiotic therapy
Routine antibiotic therapy	1522	395,043	Reference	$1,862,478	Reference	0.0	0.0
Indicated antibiotic therapy	3882	421,544	10,085	$1,999,152	$13.6/LYS	0.0	100.0
100% program coverage for indicated antibiotic therapy; 19.6% coverage for routine antibiotic therapy
Routine antibiotic therapy	1522	395,043	Reference	$1,862,478	Reference	0.0	0.0
Indicated antibiotic therapy	7764	464,411	26,399	$2,221,611	$13.6/LYS	0.0	100.0

^aDiscounted at an annual rate of 3.5%
^bBased on probabilistic sensitivity analysis, where “dominant” means higher LYS and lower costs compared to the competing strategy
^cBased on probabilistic sensitivity analysis, where “optimal” is based on a cost-effectiveness threshold of $378/LYS for Niger

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