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- Title
Economic value of using partially hydrolysed infant formula for risk reduction of atopic dermatitis in high-risk, not exclusively breastfed infants in Singapore.
- Authors
Botteman, Marc F.; Bhanegaonkar, Abhijeet J.; Horodniceanu, Erica G.; Xiang Ji; Bee Wah Lee; Shek, Lynette P.; Van Bever, Hugo P. S.; Detzel, Patrick; Ji, Xiang; Lee, Bee Wah; Van Bever, Hugo Ps
- Abstract
<bold>Introduction: </bold>Previous trials have demonstrated reductions in atopic dermatitis (AD) incidence when healthy, high-risk, non-exclusively breastfed infants were fed until four months of age with 100% whey-based partially hydrolysed formula (PHF-W) versus standard cow's milk formula (CMF). We assessed the cost-effectiveness of this intervention in Singapore.<bold>Methods: </bold>Modelling techniques were used to simulate, from birth to Month 30, the incidence and clinical/economic burden of AD in high-risk, non-exclusively breastfed infants fed with PHF-W or CMF for up to four months. Epidemiologic and clinical data were from a local comparative trial. Expert opinion informed AD treatment patterns and outcomes. Outcomes included reduction in AD risk, time spent with AD, days without AD flare, quality-adjusted life years (QALYs) and direct/indirect costs. Multivariate probabilistic sensitivity analysis was used to assess model parameter uncertainty.<bold>Results: </bold>Over 30 months, with the use of PHF-W instead of CMF, the proportion of children who developed AD and the time spent with AD decreased by 16.0% (28.3% vs. 44.3%) and 6.4 months, respectively, while time without AD flare and QALYs increased by 14.9 days and 0.021 QALYs per patient, respectively. Estimated AD-related discounted costs per child for PHF-W and CMF were SGD 771 and SGD 1,309, respectively (net savings: SGD 538). PHF-W was less expensive and more effective than CMF for 73%, and cost less than SGD 50,000 per QALY for 87% of all multivariate simulations.<bold>Conclusion: </bold>Early short-term nutritional intervention with PHF-W instead of CMF may reduce AD incidence and costs for healthy, high-risk, non-exclusively breastfed infants in Singapore.
- Subjects
ATOPIC dermatitis; MILK; EPIDEMIOLOGY; COST effectiveness; MEDICAL economics
- Publication
Singapore Medical Journal, 2018, Vol 59, Issue 8, p439
- ISSN
0037-5675
- Publication type
journal article
- DOI
10.11622/smedj.2017113