Latin American Clinical Epidemiology Network Series – Paper 4: Economic evaluation of Kangaroo Mother Care: cost utility analysis of results from a randomized controlled trial conducted in Bogotá

• Published in: Journal of clinical epidemiology 2017-06, Vol.86, p.91-100
• Main Authors: Ruiz, Juan Gabriel, Charpak, Nathalie, Castillo, Mario, Bernal, Astrid, Ríos, John, Trujillo, Tammy, Córdoba, María Adelaida
• Format: Article
• Language: English
• Subjects: Birth weight; Breast Feeding - economics; Breastfeeding & lactation; Clinical trials; Colombia; Confidence intervals; Cost analysis; Cost comparison; Cost control; Cost-Benefit Analysis - economics; Cost-Benefit Analysis - statistics & numerical data; Cost-effectiveness analysis; Developing countries; Economic analysis; Economics; Epidemiologic Studies; Epidemiology; Extrapolation; Female; Humans; Infant; Infant, Low Birth Weight - growth & development; Infant, Newborn; Infant, Premature - growth & development; Infants; Intervention; Kangaroo mother care method; Kangaroo-Mother Care Method - economics; Kangaroo-Mother Care Method - statistics & numerical data; Latin America; LDCs; Low income groups; Male; Newborn babies; Nutrition; Pediatrics; Premature; Quality-Adjusted Life Years; Randomization; Randomized controlled trial; Sensitivity analysis; Skin; Studies; Weight Gain
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2016.10.007

Although kangaroo mother care (KMC) has been shown to be safe and effective in randomized controlled trials (RCTs), there are no published complete economic evaluations including the three components of the full intervention. A cost utility analysis performed on the results of an RCT conducted in Bogotá, Colombia between 1993 and 1996. Hospital and ambulatory costs were estimated by microcosting in a sample of preterm infants from a University Hospital in Bogotá in 2011 and at a KMC clinic in the same period. Utility scores were assigned by experts by means of (1) direct ordering and scoring discrete health states and (2) constructing a multi-attribute utility function. Ninety-five percent confidence intervals (CIs) for the incremental cost–utility ratios (ICURs) were computed by the Fiellers theorem method. One-way sensitivity analysis on price estimates for valuing costs was performed. ICUR at 1 year of corrected age was $ −1,546 per extra quality-adjusted life year gained using the KMC method (95% CI $ −7,963 to $ 4,910). In Bogotá, the use of KMC is dominant: more effective and cost-saving. Although results from an economic analysis should not be extrapolated to different systems and communities, this dominant result suggests that KMC could be cost-effective in similar low and middle income countries settings.