Cost-effectiveness of partially-hydrolyzed formula for prevention of atopic dermatitis in Australia.
OBJECTIVE
To perform an economic evaluation of a specific brand of partially hydrolyzed infant formula (PHF-W) in the prevention of atopic dermatitis (AD) among Australian infants.


METHODS
A cost-effectiveness analysis was undertaken from the perspectives of the Department of Health and Aging (DHA), of the family of the affected subject and of society as a whole in Australia, based on a decision-analytic model following a hypothetical representative cohort of Australian newborns who are not exclusively breastfed and who have a familial history of allergic disease (i.e., are deemed 'at risk'). Costs, consequences, and incremental cost-effectiveness ratios (ICER) were calculated for PHF-W vs standard cow's milk based infant formula (SF), and, in a secondary analysis, vs extensively hydrolyzed infant formula (EHF-Whey), when the latter was used for the prevention of AD.


RESULTS
From a representative starting cohort of 87,724 'at risk' newborns in Australia in 2009, the expected ICERs for PHF-W vs SF were AU$496 from the perspective of the DHA and savings of AUD1739 and AU$1243 from the family and societal perspectives, respectively. When compared to EHF-Whey, PHF-W was associated with savings for the cohort of AU$5,183,474 and AU$6,736,513 from the DHA and societal perspectives.


CONCLUSIONS
The generalizability and transferability of results to other settings, populations, or brands of infant formula should be made with caution. Whenever possible, a conservative approach directing bias against PHF-W rather than its comparators was applied in the base case analysis. Assumptions were verified in one-way and probabilistic sensitivity analyses, which confirmed the robustness of the model.


CONCLUSIONS
PHF-W appears to be cost-effective when compared to SF from the DHA perspective, dominant over SF from the other perspectives, and dominant over EHF-Whey from all perspectives, in the prevention of AD in 'at risk' infants not exclusively breastfed, in Australia.
Department of Dermatology, Royal Children's Hospital, University of Melbourne, Melbourne, Australia; Monash University, Melbourne, Australia.
John
J
Su
Susan
S
Prescott
John
J
Sinn
Mimi
M
Tang
Peter
P
Smith
Ralf G
RG
Heine
Jörg
J
Spieldenner
Michael
M
Iskedjian
D000818:Animals; D001315:Australia; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003876:Dermatitis, Atopic / Q000191:economics / Q000517:prevention & control*; D020022:Genetic Predisposition to Disease; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006868:Hydrolysis; D015994:Incidence; D007223:Infant; D041943:Infant Formula / Q000737:chemistry* / Q000191:economics*; D007231:Infant, Newborn; D008892:Milk / Q000009:adverse effects / Q000191:economics; D008894:Milk Proteins / Q000009:adverse effects / Q000191:economics; D017059:Models, Econometric; D012307:Risk Factors; D013997:Time Factors; D000067816:Whey Proteins
D008894:Milk Proteins; D000067816:Whey Proteins