@article{article,
  keywords = {Schistosomiasis , arpraziquantel, Pre-school age children, Early economic evaluation, Economic model},
  author = {Chua B and Chaowanasawat P and Tsui T and Teerawattananon Y and Mwing{\textquoteright}a G and Omolo J and Kazyoba P},
  title = {Cost-benefit analysis of arpraziquantel compared to standard of care for schistosomiasis among pre-school age children in Tanzania: an early health economic evaluation},
  abstract = {<p><strong>Background</strong></p>

<p>Pre-school age children (pre-SAC) have been excluded from schistosomiasis mass drug administration (MDA) programs, as suitable pediatric formulations were lacking. Arpraziquantel, a newly approved oral dispersible tablet, addresses this gap. We conducted an early economic evaluation to assess the potential value of arpraziquantel in Tanzania, informing implementation research and evidence generation priorities.</p>

<p><strong>Methods</strong></p>

<p>Following the cost-benefit analysis (CBA) reference case, we conducted a CBA from the societal perspective using a Markov model, simulating a cohort of Tanzanian 2-year-olds over 3-year and 12-year horizons. Potential future wage gains were assessed with a lifetime horizon. Two arpraziquantel strategies were compared against standard of care (no treatment): MDA, and test-and-treat (T\&amp;T). Disability-adjusted life years (DALYs) averted, averted healthcare and caregiver costs, and wage gains were monetized. Results were summarized as net benefit (NB) and benefit-cost ratio (BCR). Probabilistic, threshold, scenario and value-of-information analyses were performed.</p>

<p><strong>Findings</strong></p>

<p>Over three years, for approximately 57,000 pre-SAC, the estimated NB of MDA was $522,289 (BCR: 2.10); T\&amp;T yielded $227 (BCR: 1.00). Over 12 years, projected NB was higher for MDA ($1,119,330) and T\&amp;T ($378,953). Both MDA and T\&amp;T estimated positive NB when potential future wages were considered. In probabilistic analysis, MDA estimated positive NB in \&gt;86\% of simulations, but T\&amp;T estimated net losses in 50\% of simulations over 3 years. Arpraziquantel cost drove decision uncertainty.</p>
},
  year = {2026},
  journal = {The Lancet Regional Health - Africa},
  pages = {1 - 14},
  month = {10/2026},
  publisher = {Elsevier BV},
  issn = {3050-5011},
  url = {https://www.thelancet.com/action/showPdf?pii=S3050-5011\%2826\%2900155-0},
  doi = {10.1016/j.lanafr.2026.100174},
  language = {ENG},
}