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Cost-effectiveness of club-foot treatment in low-income and middle-income countries by the Ponseti method

Grimes, Caris E ; Holmer, Hampus LU ; Maraka, Jane ; Ayana, Birhanu ; Hansen, Linda and Lavy, Christopher B D (2016) In BMJ Global Health 1(1). p.000023-000023
Abstract

BACKGROUND: Club foot is a common congenital deformity affecting 150 000-200 000 children every year. Untreated patients end up walking on the side or back of the affected foot, with severe social and economic consequences. Club foot is highly treatable by the Ponseti method, a non-invasive technique that has been described as highly suitable for use in resource-limited settings. To date, there has been no evaluation of its cost-effectiveness ratio, defined as the cost of averting one disability-adjusted life year (DALY), a composite measure of the impact of premature death and disability. In this study, we aimed to calculate the average cost-effectiveness ratio of the Ponseti method for correcting club foot in sub-Saharan... (More)

BACKGROUND: Club foot is a common congenital deformity affecting 150 000-200 000 children every year. Untreated patients end up walking on the side or back of the affected foot, with severe social and economic consequences. Club foot is highly treatable by the Ponseti method, a non-invasive technique that has been described as highly suitable for use in resource-limited settings. To date, there has been no evaluation of its cost-effectiveness ratio, defined as the cost of averting one disability-adjusted life year (DALY), a composite measure of the impact of premature death and disability. In this study, we aimed to calculate the average cost-effectiveness ratio of the Ponseti method for correcting club foot in sub-Saharan Africa.

METHODS: Using data from 12 sub-Saharan African countries provided by the international non-profit organisation CURE Clubfoot, which implements several Ponseti treatment programmes around the world, we estimated the average cost of the point-of-care treatment for club foot in these countries. We divided the cost of treatment with the average number of DALYs that can be averted by the Ponseti treatment, assuming treatment is successful in 90% of patients.

RESULTS: We found the average cost of the Ponseti treatment to be US$167 per patient. The average number of DALYs averted was 7.42, yielding a cost-effectiveness ratio of US$22.46 per DALY averted. To test the robustness of our calculation different variables were used and these yielded a cost range of US$5.28-29.75. This is less than a tenth of the cost of many other treatment modalities used in resource-poor settings today.

CONCLUSIONS: The Ponseti method for the treatment of club foot is cost-effective and practical in a low-income country setting. These findings could be used to raise the priority for implementing Ponseti treatment in areas where patients are still lacking access to the life-changing intervention.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
in
BMJ Global Health
volume
1
issue
1
pages
000023 - 000023
publisher
BMJ Publishing Group
external identifiers
  • scopus:85049997431
  • pmid:28588918
ISSN
2059-7908
DOI
10.1136/bmjgh-2015-000023
project
Measuring global surgery, obstetrics and anaesthesia – from health systems to patients
language
English
LU publication?
yes
id
47394d8b-cdfb-4331-9d0b-8e773d43635c
date added to LUP
2018-10-22 10:13:40
date last changed
2024-05-27 19:37:11
@article{47394d8b-cdfb-4331-9d0b-8e773d43635c,
  abstract     = {{<p>BACKGROUND: Club foot is a common congenital deformity affecting 150 000-200 000 children every year. Untreated patients end up walking on the side or back of the affected foot, with severe social and economic consequences. Club foot is highly treatable by the Ponseti method, a non-invasive technique that has been described as highly suitable for use in resource-limited settings. To date, there has been no evaluation of its cost-effectiveness ratio, defined as the cost of averting one disability-adjusted life year (DALY), a composite measure of the impact of premature death and disability. In this study, we aimed to calculate the average cost-effectiveness ratio of the Ponseti method for correcting club foot in sub-Saharan Africa.</p><p>METHODS: Using data from 12 sub-Saharan African countries provided by the international non-profit organisation CURE Clubfoot, which implements several Ponseti treatment programmes around the world, we estimated the average cost of the point-of-care treatment for club foot in these countries. We divided the cost of treatment with the average number of DALYs that can be averted by the Ponseti treatment, assuming treatment is successful in 90% of patients.</p><p>RESULTS: We found the average cost of the Ponseti treatment to be US$167 per patient. The average number of DALYs averted was 7.42, yielding a cost-effectiveness ratio of US$22.46 per DALY averted. To test the robustness of our calculation different variables were used and these yielded a cost range of US$5.28-29.75. This is less than a tenth of the cost of many other treatment modalities used in resource-poor settings today.</p><p>CONCLUSIONS: The Ponseti method for the treatment of club foot is cost-effective and practical in a low-income country setting. These findings could be used to raise the priority for implementing Ponseti treatment in areas where patients are still lacking access to the life-changing intervention.</p>}},
  author       = {{Grimes, Caris E and Holmer, Hampus and Maraka, Jane and Ayana, Birhanu and Hansen, Linda and Lavy, Christopher B D}},
  issn         = {{2059-7908}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{000023--000023}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Global Health}},
  title        = {{Cost-effectiveness of club-foot treatment in low-income and middle-income countries by the Ponseti method}},
  url          = {{http://dx.doi.org/10.1136/bmjgh-2015-000023}},
  doi          = {{10.1136/bmjgh-2015-000023}},
  volume       = {{1}},
  year         = {{2016}},
}