title: Economic evaluation of a 100% whey-based partially hydrolyzed infant formula in the prevention of atopic dermatitis among Danish children.
abstract: OBJECTIVE
  A pharmacoeconomic analysis was undertaken to determine costs, consequences, and cost-effectiveness of a brand of partially hydrolyzed 100%-whey formula manufactured by Nestlé (PHF-W), in the prevention of atopic dermatitis (AD) in 'at risk' Danish children compared to extensively hydrolyzed formula (EHF-Whey or Casein).
  
  
  METHODS
  Given the non-significant differences between PHF-W and EHF, the base case analytic approach amounted to a cost-minimization analysis (CMA) reporting the difference in formula acquisition costs over the period of formula consumption for the population of interest. However, sensitivity analyses (SAs) were undertaken to explore applying the nominal efficacy of PHF-W and EHF, thus leading to a cost-effectiveness analysis (CEA). Hence, an economic model based on a 12-month time horizon was developed synthesizing treatment pathways, resource utilization, and costs associated with the treatment of AD in the population of interest. The final economic outcome of the SAs was the incremental cost per avoided case (ICER) defined as the expected cost per avoided case of AD for PHF-W vs EHF, determined from three perspectives: the Ministry of Health (MOH), the family of the subject, and society (SOC).
  
  
  RESULTS
  In the base case CMA, savings of DKK 9 M, DKK 20 M, and DKK 29 M were generated for PHF-W vs EHF from the MOH, family, and SOC perspectives. In the sensitivity CEA, PHF-W was dominant over EHF-Whey from all perspectives, while EHF-Casein displayed against PHF-W unattractive ICERs of DKK 315,930, DKK 408,407, and DKK 724,337 from the MOH, family, and SOC perspectives. Probabilistic SAs indicated that PHF-W was 86% likely to be dominant over EHF-Whey, whereas EHF-Casein had no likelihood of dominating PHF-W.
  
  
  CONCLUSIONS
  Under a range of assumptions, this analysis demonstrated the attractiveness of PHF-W vs both types of EHF in the prevention of AD among 'at risk' Danish infants who are not or cannot be exclusively breastfed.
authors.affiliation: PharmIdeas Research and Consulting Inc., Oakville, ON, Canada, PharmIdeas Europe SAS, Lyon, France, and Université de Montréal, Montréal, QC, Canada. miskedjian@pharmideas.com
authors.forename: Michael
authors.initials: M
authors.lastname: Iskedjian
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Haschke
authors.forename: Bechara
authors.initials: B
authors.lastname: Farah
authors.forename: Jenny
authors.initials: J
authors.lastname: van Odijk
authors.forename: Jade
authors.initials: J
authors.lastname: Berbari
authors.forename: Jörg
authors.initials: J
authors.lastname: Spieldenner
mesh_terms: D002364:Caseins / Q000191:economics; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003718:Denmark; D003876:Dermatitis, Atopic / Q000191:economics* / Q000517:prevention & control*; D004044:Dietary Proteins; D017850:Economics, Pharmaceutical; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000737:chemistry / Q000191:economics*; D016269:Milk Hypersensitivity; D008894:Milk Proteins; D018803:Models, Economic; D017063:Outcome Assessment, Health Care; D012680:Sensitivity and Specificity; D000067816:Whey Proteins
chemical_list: D002364:Caseins; D004044:Dietary Proteins; D008894:Milk Proteins; D000067816:Whey Proteins