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Is prevention of atopic eczema with hydrolyzed formulas cost-effective? A health economic evaluation from Germany.
Pediatr. Allergy Immunol. 23, 597-604 (2012)
To cite this article: Mertens J, Stock S, Lungen M, Berg AV, Kramer U, Filipiak-Pittroff B, Heinrich J, Koletzko S, Grubl A, Wichmann H-E, Bauer C-P, Reinhardt D, Berdel D, Gerber A. Is Prevention of Atopic Eczema with Hydrolyzed Formulas Cost-Effective? A Health Economic Evaluation from Germany. Pediatr Allergy Immunol 2012: 23: 597604. Abstract Objective: The German Infant Nutritional Intervention (GINI) trial, a prospective, randomized, double-blind intervention, enrolled children with a hereditary risk for atopy. When fed with certain hydrolyzed formulas for the first 4 months of life, the risk was reduced by 2645% in PP and 829% in intention-to-treat (ITT) analyses compared with children fed with regular cows milk at age 6. The objective was to assess the cost-effectiveness of feeding hydrolyzed formulas. Patients and Methods: Cost-effectiveness was assessed with a decision tree model programmed in TreeAge. Costs and effects over a 6-yr period were analyzed from the perspective of the German statutory health insurance (SHI) and a societal perspective at a 3% effective discount rate followed by sensitivity analyses. Results: The extensively hydrolyzed casein formula would be the most cost-saving strategy with savings of 478 (sic) per child treated in the ITT analysis (CI95%: 12 (sic); 852 (sic)) and 979 (sic) in the PP analysis (95%CI: 355 (sic); 1455 (sic)) from a societal perspective. If prevented cases are considered, the partially whey hydrolyzed formula is cost-saving (ITT -5404 (sic), PP -6358 (sic)). From an SHI perspective, the partially whey hydrolyzed formula is cost-effective, but may also be cost-saving depending on the scenario. An extensively hydrolyzed whey formula also included into the analysis was dominated in all analyses. Conclusions: For the prevention of AE, two formulas can be cost-effective or even cost-saving. We recommend that SHI should reimburse formula feeding or at least the difference between costs for cows milk formula and the most cost-effective formula.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Atopic Dermatitis ; Atopic Eczema ; Cost-effectiveness Analysis ; Hydrolyzed Formula ; Nutrition ; Prevention; INFANT NUTRITIONAL INTERVENTION; BIRTH COHORT; DERMATITIS; CHILDREN; METAANALYSIS; CHILDHOOD; DISEASES; ILLNESS; ASTHMA; LIFE
ISSN (print) / ISBN
0905-6157
e-ISSN
1399-3038
Zeitschrift
Pediatric Allergy and Immunology
Quellenangaben
Band: 23,
Heft: 6,
Seiten: 597-604
Verlag
Wiley
Nichtpatentliteratur
Publikationen
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute of Epidemiology (EPI)