Zinc and copper supplementation are not cost-effective interventions in the treatment of acute diarrhea.

BACKGROUND: Diarrhea is one of the principal causes of morbidity and mortality among children in the developing world. Cumulative costs of treating diarrhea would be high and would further increase if zinc was used as an adjunct to treatment of acute diarrhea. OBJECTIVE: To determine the impact of zinc supplementation on the mean predicted costs of treating acute diarrhea and the incremental cost-effectiveness (CE) as compared with placebo, from the provider's (government) and patient's perspective. STUDY DESIGN AND SETTING: In a randomized, double-blind, placebo-controlled clinical trial, 808 children aged 6-59 months with acute diarrhea were individually randomized to placebo (Pl), zinc (Zn) only, and zinc and copper (Zn + Cu) together with standard treatment of acute diarrhea. The actual resource utilization and cost data were collected for all participants. The incremental CE ratio and its 95% confidence interval (95% CI) were assessed. RESULTS: The relative CE for treating acute diarrhea was 1.5 (95% CI: 1.50, 1.52) times more when supplemented with zinc and 1.7 (95% CI: 1.69, 1.71) times more when supplemented with Zn + Cu with no additional beneficial effect. CONCLUSION: This study showed that zinc or zinc with copper supplementation were not cost-effective in the treatment of acute diarrhea in this study population.