title: Relative cost-effectiveness of using a liquid human milk fortifier in preterm infants in the US.
abstract: OBJECTIVE
  To human milk fortifier (LHMF) compared to a powdered human milk fortifier (PHMF) in preterm infants in the US from the perspective of third-party payers and parents.
  
  
  METHODS
  This was a decision modelling study using patient data obtained from a randomized controlled trial comparing a LHMF with a PHMF in preterm infants, supplemented with additional data obtained by performing a chart review among 79% of the trial patients. The model estimated the cost-effectiveness of LHMF versus PHMF in US$ at 2014/2015 prices.
  
  
  RESULTS
  More infants in the LHMF group were discharged home (92% versus 89%) and more infants in the PHMF group were transferred to another unit (9% versus 5%). Gestational age was an independent predictor for being discharged home (odds ratio of 2.18;p=0.006 for each week of gestational age). Mean length of neonatal intensive care unit (NICU) stay was 1 day less in the LHMF than the PHMF group (62.3 versus 63.4 days), but mean length of NICU stay among infants who developed NEC or sepsis was 79.3 days and 61.2 days in the PHMF and LHMF groups, respectively. Total management cost up to discharge was $10,497 per infant less in the LHMF group than the PHMF group ($240,928 versus $251,425).
  
  
  CONCLUSIONS
  Using LHMF instead of PHMF in preterm infants enabled resources to be freed-up for alternative use within the system. There is no health economic reason why LHMF should not be used in preference to PHMF in the NICU.
authors.affiliation: Catalyst Health Economics Consultants, Northwood, Middlesex, UK; Faculty of Life Sciences and Medicine, King's College, London, UK.
authors.forename: Julian F
authors.initials: JF
authors.lastname: Guest
authors.affiliation: Coastal Carolina Neonatology, Wilmington, NC, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Moya
authors.affiliation: Novant Health Forsyth Medical Center, Winston Salem, NC, USA.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Sisk
authors.affiliation: Department of Pediatrics, University of Florida College of Medicine, Jacksonville, FL, USA.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Hudak
authors.affiliation: Department of Pediatrics, East Carolina University, Greenville, NC, USA.
authors.forename: Devon
authors.initials: D
authors.lastname: Kuehn
keywords: US; cost-effectiveness; milk fortifiers; neonatal intensive care; preterm infants