Following the cost-effectiveness study of the Inspire2Care pilot in 2014, this year a new cost effectiveness study was carried out on the scaling-up program of Inspire2Care in Ilam district.
In total an estimated 1,926 DALYs were averted using the 2004 weights and 878 using the 2016 weights. This gives a cost per DALY averted of EUR 384-843 depending on the weights used. Estimated expenditures for batch 3 and results in line with batch 2 would result in a batch 3
cost per DALY averted of EUR 322-693. The anticipated cost-effectiveness of the CBR component of I2C in the planned replication prototype municipality, excluding Karuna Foundation Netherlands expenditures and Karuna Foundation Nepal indirect administrative expenses, is EUR 51-107.
This cost per Disability-Adjusted Life Years (DALY) averted is well within the reach of the Government of Nepal. Using WHO benchmarks, I2C Ilam is still considered highly cost-effective or cost-effective, depending on the batch assessed and disability weights used.
Longer-term outlooks for incorporation into the government system and sustainability through local systems are good from the perspective of cost-effectiveness and financial sustainability, in that the program is designed to be sustainable and shows evidence in batches 1 and 2 of being so. Additionally, planned changes to the program for the replication strengthen sustainability even further.