# The Cost of Annual and More Frequent Than Annual Mass Drug Administration for Trachoma in Two Districts in Amhara, Ethiopia

## TL;DR

This study estimates the cost of a modified mass drug administration strategy for trachoma in two districts of Ethiopia to help guide public health decisions.

## Contribution

The study provides new cost data for a child-focused mass drug administration strategy in trachoma-endemic areas.

## Key findings

- The total financial cost of the CMDA strategy was $106,427 across two districts.
- The cost per treatment ranged from $0.26 to $0.37 depending on the district.
- The findings can inform cost-effectiveness analyses and decision-making for trachoma elimination.

## Abstract

Ethiopia accounts for 59% of the global trachoma burden. To eliminate trachoma as a public health problem by 2030, modified mass drug administration (MDA) strategies have been proposed, including more frequent than annual MDA. In the present study, the cost of the “child MDA” (CMDA) strategy, defined as an initial community-wide MDA treatment followed by another treatment targeting children aged 6 months to 9 years, was estimated in the Lasta and Wadilla districts, Amhara, Ethiopia. A micro-costing analysis was conducted from a payer perspective, documenting the total financial and economic cost, cost per person treated, and cost per treatment. The cost per person treated was calculated by dividing the total cost by the total number of people treated during the community-wide MDA distribution. The cost per treatment was calculated by dividing the total cost by the total number of treatments distributed overall. The total financial cost of implementing the CMDA strategy in Lasta and Wadilla was $106,427, corresponding to a financial cost per person treated of $0.41 and a financial cost per treatment of $0.32. In Lasta, 168,175 treatments were distributed at a financial cost of $61,978, corresponding to a cost per person of $0.48 and a cost per treatment of $0.37. In Wadilla, 169,248 treatments were distributed at a financial cost of $44,449, corresponding to a cost per person of $0.34 and a cost per treatment of $0.26. This information is useful to stakeholders considering the CMDA strategy in similar contexts and may contribute to future cost-effectiveness analyses of the strategy.