Cost of mass annual single dose diethylcarbamazine distribution for the large scale control of lymphatic filariasis

Economic analysis of the revised strategy to control lymphatic filariasis w ith mass annual single dose diethylcarbamazine (DEC) at 6 mg/kg body weight launched in one of the districts of Tamil Nadu in 1996 was carried out. Th is exploratory study, proposed for five years in 13 districts under 7 state s on a pilot scale through the Department of Public Health is an additional input of the existing National Filaria Control Programme in India. A retro spective costing exercise was undertaken systematically from the provider's perspective following the completion of the first round of drug distributi on. The major activities and cost components were identified and itemized c ost menu was prepared to estimate the direct (financial) and indirect (oppo rtunity) cost related to the implementation of the Programme. The total fin ancial cost of this Programme to cover 22.7 lakh population in the district was Rs. 22.05 lakhs. The opportunity cost of labour and capital investment was calculated to be Rs. 7.98 lakhs. The total per capita cost was Rs. 1.3 2, with Rs. 0.97 and Rs. 0.35 as financial and opportunity cost respectivel y. Based on these estimates, the implementation cost of the Programme at Pr imary Health Centre (PHC) level was calculated and projected for five years . The additional financial cost for the existing health care system is esti mated to be Rs.27,800 per PHC every year. DEC tablets (50 mg) was the major cost component and sensitivity analysis showed that the cost of the Progra mme could be minimized by 20 per cent by switching over to 100 mg tablets. The analysis indicates that this Programme is a low-cost option and the res ults are discussed in view of its operational feasibility and epidemiologic al impact.