title: Partially hydrolysed 100% whey-based infant formula and the prevention of atopic dermatitis: comparative pharmacoeconomic analyses.
abstract: Clinical trials have demonstrated that the risk of developing atopic dermatitis is reduced when using hydrolysed formulas to feed infants with a documented risk of atopy (i.e. an affected parent and/or sibling)when breastfeeding is not practised. However, little is known about the cost-effectiveness of using hydrolysed formulas. Consequently, economic analyses in 5 European countries (Denmark, France, Germany, Spain and Switzerland) have evaluated the costs and cost-effectiveness of a specific brand of 100% whey-based partially hydrolysed infant formula, NAN-HA® (PHF-W) compared with a cow's milk standard formula (SF) in the prevention of atopic dermatitis in at-risk children. This review synthesises the findings of these studies. Cost-effectiveness analyses (CEA) used a decision-analytic model to determine treatment pathways, resource utilisation and costs associated with the management of atopic dermatitis in healthy at-risk newborns who were not exclusively breastfed. The model had a 12-month horizon and applied reimbursement rates of 60-100% depending on the country. Outcomes were considered from the perspective of the public healthcare system (e.g. the Ministry of Health; MOH), family and society. The final outcome was the incremental cost-effectiveness ratio per avoided case of atopic dermatitis (ICER) for PHF-W versus SF. A cost-minimisation analysis was also performed to compare PHF-W with extensively hydrolysed formulas (EHF). The base-case CEA produced ICERs per avoided case for PHF-W versus SF of EUR 982-1,343 (MOH perspective), EUR -2,202 to -624 (family perspective) indicating savings, and EUR -1,220 to 719 from the societal perspective. The main costs related to formula (MOH and society) and time loss (family). In the cost-minimisation analysis, PHF-W yielded savings of between EUR 4.3 and 120 million compared with EHF-whey when the latter was used in prevention. In conclusion, PHF-W was cost-effective versus SF in the prevention of atopic dermatitis and cost saving compared with EHF when used in prevention.
authors.affiliation: Nestlé Nutrition Institute, Avenue Reller 22, Vevey, Switzerland. joerg.spieldenner@nestle.com
authors.forename: Jörg
authors.initials: J
authors.lastname: Spieldenner
authors.forename: Dominique
authors.initials: D
authors.lastname: Belli
authors.forename: Christophe
authors.initials: C
authors.lastname: Dupont
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Haschke
authors.forename: Michael
authors.initials: M
authors.lastname: Iskedjian
authors.forename: Santiago
authors.initials: S
authors.lastname: Nevot Falcó
authors.forename: Hania
authors.initials: H
authors.lastname: Szajewska
authors.forename: Andrea
authors.initials: A
authors.lastname: von Berg
mesh_terms: D017046:Cost Savings; D003876:Dermatitis, Atopic / Q000191:economics / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D006868:Hydrolysis; D007223:Infant; D041943:Infant Formula / Q000737:chemistry* / Q000191:economics; D007231:Infant, Newborn; D008894:Milk Proteins / Q000008:administration & dosage* / Q000191:economics; D011492:Protein Hydrolysates / Q000008:administration & dosage*; D012307:Risk Factors; D000067816:Whey Proteins
chemical_list: D008894:Milk Proteins; D011492:Protein Hydrolysates; D000067816:Whey Proteins