Quantifying the lifetime economic impact of pediatric oral nutritional supplements

INTRODUCTION: Pediatric malnutrition is a significant global public health challenge, particularly in low- and middle-income countries. This study quantifies the lifetime, per-person economic impact of pediatric oral nutritional supplements (ONS) for children at risk of undernutrition. METHODS: A decision tree model was constructed to assess the impact of pediatric ONS on health and economic outcomes of children at risk for undernutrition in India. Outcomes included changes in mean childhood height-for-age Z-score (HAZ), morbidity, and lifetime earnings. Total net incremental value was modeled as the sum of future earnings and quality-of-life benefits net the intervention costs. The model used a lifetime perspective at the individual level, discounted at 3%. RESULTS: Compared to the standard of care, pediatric ONS use increased mean HAZ by 0.125. This increase in height was projected to improve health outcomes by 0.28 in quality adjusted life-years (valued at $1019 per person) and lifetime economic earnings by $471 per person. The total lifetime incremental value of ONS was $1281 per person net of lifetime pediatric ONS costs of $210. The model estimated a 5.63% internal rate of return on incremental earnings from pediatric ONS. The model was most sensitive to changes in HAZ scores and the height-wage premium. DISCUSSION: Pediatric ONS is predicted to improve both quality-of-life and economic outcomes for children at risk of undernutrition in India. These findings underscore the value of integrating nutritional interventions into public health strategies to address childhood undernutrition, with implications for global health policy.