Presentation (CTI)

OBJECTIVES: Undernutrition (wasting, stunting, and underweight) remains a major health issue in Indonesia. Children affected by undernutrition are more likely to suffer from infections e.g. tuberculosis (TB), pneumonia, acute respiratory infections (ARI), and diarrhea. Nutrient-dense formula (NDF) has shown promise to improve health outcomes in these children.
METHODS: A cost-utility analysis (CUA) was performed using a decision tree model. The analysis incorporated both reductions in the incidence and direct cost treatments of TB, pneumonia, diarrhea, and ARI, as well as gains in quality-adjusted life years (QALYs) over a five-year time horizon. Disease incidence rates were modelled based on estimated frequencies, with TB and pneumonia assessed annually, ARI four times a year, and diarrhoea three times a year. Local data on malnutrition-related illnesses and conditions in children were gathered and analysed to determine the cost-effectiveness of nutritional interventions.
RESULTS: NDF administration could prevent approximately 1.6M cases of stunting, 1.2M cases of wasting, and 1.9M cases of underweight. It also may reduce the incidence of TB, pneumonia, ARI, and diarrhea by 47.2% (1.2M), 44.7% (1M), 47.2% (2.6M), and 48.9% (2M), respectively. These reductions are also associated with substantial cost savings: IDR 2.46T for TB, IDR 3.88T for pneumonia, IDR 2.40T for ARI, and IDR 3.38T for diarrhea. ICER of IDR 6.23M per QALY (€372.30/QALY), which is well below Indonesia’s cost-effectiveness threshold of three times the GDP per capita.
CONCLUSIONS: The provision of NDF to children with nutritional deficiencies represents a cost-effective public health strategy in Indonesia. This intervention potentially prevents the progression of adverse health outcomes associated with undernutrition, while also reducing the economic burden on the healthcare system through decreased treatment costs.