Page 177 - 15Diarrhoeaandvomiting

Diarrhoea and vomiting caused by gastroenteritis in children under 5 years

The sensitivity analysis depicted in Figure A.4 shows, unsurprisingly, that the cost-minimisation
results are sensitive to the cost of ORT (or, more accurately, the cost differential between the two
treatment alternatives). The analysis shows that, as long as the initial ORT treatment cost is less
than £653 (or its initial treatment cost is at least £48 cheaper than the initial treatment cost for
IVT), then it remains the cheapest option even when considering ‘downstream’ costs.

The PSA in Figure A.5 suggests that there is a 100% probability that ORT is the cheapest option.
Unsurprisingly, the graph shows a negative relationship between the cost of ORT and the
incremental costs of IVT (as the latter is a function of the former). In the PSA simulations, ORT is
relatively more expensive when higher treatment failure values and/or higher rates of paralytic
ileus are sampled. Similarly, the cost of IVT may also vary depending on the sampled failure rate
of treatment and the probability of phlebitis.
The results of the ‘worst case’ sensitivity analysis show that, even in the least favourable
circumstances, ORT remains the more cost-effective option, therefore strengthening the case for
its use in the treatment of dehydrated children.

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