Objectives
We estimate the cost-effectiveness of price subsidies on fortified packaged complementary foods (FPCFs) in reducing iron deficiency anemia (IDA) and vitamin A deficiency (VAD) and the related health consequences in 6-23-month-old children in Pakistan.
Methods
First, we determined the current lifetime costs of IDA and VAD with a health economic model that combines the prevalence of IDA and VAD with information on the health consequences and their costs in terms of mortality, morbidity, and disability-adjusted life-years (DALYs). Second, we conducted a household survey in 2015 covering 1684 households in 2 large districts in Pakistan, to assess the price sensitivity of demand for FPCFs. Third, we estimated the cost-effectiveness of different price-based interventions on FPCFs by combining the findings of the first two steps with the results of a systematic review on the effectiveness of FPCFs in reducing IDA and VAD.
Results
The lifetime social costs of IDA and VAD in 6-23-month-old children in the two examined districts amount to production losses of 180m USD and to 165â000 DALYs, with poor households incurring the highest costs. We also find that poorer households are less likely to buy FPCFs, with the share ranging from 20% in the poorest to 53% in the wealthiest SES. We find that interventions targeted at poorer households are most cost-effective. The net costs of the interventions (subsidy minus production losses) range from a return per DALY averted of 32 USD to a cost of 1167 USD.
Conclusions
Price subsidies on FPICs might be a cost-effective way to reduce the social costs of IDA and VAD in 6-23-month-old children in large districts in Pakistan.
