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Published on: September 27, 2017
Cost-effectiveness of partially-hydrolyzed formula for prevention of atopic dermatitis in Australia
John Su1, Susan Prescott, John Sinn
1Department of Dermatology, Royal Children's Hospital, University of Melbourne, Melbourne, Australia; Monash University, Melbourne, Australia.
Insights
Partially hydrolyzed infant formula (PHF-W) is cost-effective for preventing atopic dermatitis in at-risk Australian infants. PHF-W offers savings compared to standard formula and extensively hydrolyzed formula across multiple perspectives.
Area of Science:
- Pediatric Nutrition
- Dermatology
- Health Economics
Background:
- Atopic dermatitis (AD) is a common condition in infants, often influenced by early feeding practices.
- Infant formulas, including partially hydrolyzed (PHF-W) and extensively hydrolyzed (EHF-Whey) options, are used for infants at risk of allergic diseases.
- Economic evaluations are crucial for understanding the cost-effectiveness of preventative strategies in infant nutrition.
Purpose of the Study:
- To conduct an economic evaluation of partially hydrolyzed infant formula (PHF-W) for preventing atopic dermatitis (AD) in Australian infants.
- To compare the cost-effectiveness of PHF-W against standard infant formula (SF) and extensively hydrolyzed infant formula (EHF-Whey).
Main Methods:
- A cost-effectiveness analysis was performed from the perspectives of the Department of Health and Aging (DHA), families, and society in Australia.
- A decision-analytic model was used, analyzing a cohort of Australian newborns at risk for AD.
- Incremental cost-effectiveness ratios (ICERs) were calculated for PHF-W versus SF and EHF-Whey.
Main Results:
- For PHF-W versus SF, the expected ICER was AU$496 from the DHA perspective, with savings of AUD1739 and AU$1243 from family and societal perspectives, respectively.
- Compared to EHF-Whey, PHF-W resulted in significant savings for the cohort: AU$5,183,474 (DHA) and AU$6,736,513 (societal).
- Sensitivity analyses confirmed the robustness of these findings.
Conclusions:
- PHF-W demonstrates cost-effectiveness compared to SF from the DHA perspective.
- PHF-W is dominant over SF from family and societal perspectives.
- PHF-W is dominant over EHF-Whey from all perspectives in preventing AD in at-risk infants not exclusively breastfed 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.
Limitations:
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.
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