Cost and budget impact of mass drug administration compared to expanded school-based targeted preventive chemotherapy for soil-transmitted helminth control in Zamboanga Peninsula, the Philippines

John Paul Caesar Delos Trinos ^1,2,3, Luc E Coffeng ⁴, Fernando Garcia ²

⁰The Kirby Institute, UNSW Sydney, NSW, Australia.

The Lancet Regional Health. Western Pacific +

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September 2, 2024

View abstract on PubMed

Summary

Mass drug administration (MDA) for soil-transmitted helminth (STH) control is more costly than school-based preventive chemotherapy (PC) but offers significant public health benefits. This approach could be crucial for reducing the STH burden.

Area Of Science

Public Health
Infectious Disease Control
Health Economics

Background

Soil-transmitted helminth (STH) infections remain a significant public health concern, particularly in regions with limited access to comprehensive control programs.
Current STH control strategies in the Philippines primarily focus on school-based preventive chemotherapy (PC) for schoolchildren, excluding adults who contribute to infection reservoirs.
Expanding control to include adults via mass drug administration (MDA) presents potential health benefits but incurs additional implementation costs.

Purpose Of The Study

To estimate the incremental economic and financial costs of implementing mass drug administration (MDA) for STH control compared to expanded school-based preventive chemotherapy (PC) in the Zamboanga Peninsula region, Philippines.
To assess the budget impact of MDA on the government's health expenditure over a five-year period.
To provide evidence for optimizing STH control strategies by comparing the cost-effectiveness of different approaches.

Main Methods

A cost survey was conducted in the Zamboanga Peninsula region in 2021.
Economic and financial costs were estimated from a government payer perspective.
Budget impact analysis and Monte Carlo simulation were used to project costs and account for uncertainty.

Main Results

The annual economic cost of MDA was estimated at $809,000 ($0.22 per person targeted), compared to $625,000 ($0.57 per person targeted) for expanded school-based PC.
Over five years, MDA's financial cost to the government was projected to be $3,113,000, which is $740,000 higher than expanded school-based PC.
Implementing MDA would represent a 29-31% increase in economic and financial costs compared to the expanded school-based PC program.

Conclusions

Mass drug administration (MDA) for STH control in the Zamboanga Peninsula is more expensive than expanded school-based preventive chemotherapy (PC).
The increased cost of MDA is estimated at 29-31%, requiring a 0.2% increase in the Department of Health's total STH control expenditure.
Despite higher costs, MDA could be a key strategy for addressing the persistent STH burden by including all population segments.

Keywords:

Budget impact analysis Cost analysis Cost survey Expanded school-based targeted preventive chemotherapy Mass drug administration Philippines Soil-transmitted helminths