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Is prevention of atopic eczema with hydrolyzed formulas cost‐effective? A health economic evaluation from Germany
Author(s) -
Mertens Janina,
Stock Stephanie,
Lüngen Markus,
Berg Andrea,
Krämer Ursula,
FilipiakPittroff Birgit,
Heinrich Joachim,
Koletzko Sibylle,
Grübl Armin,
Wichmann H.Erich,
Bauer CarlP.,
Reinhardt Dietrich,
Berdel Dietrich,
Gerber Andreas
Publication year - 2012
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/j.1399-3038.2012.01304.x
Subject(s) - medicine , cost effectiveness , cost–benefit analysis , infant formula , cost effectiveness analysis , pediatrics , risk analysis (engineering) , ecology , biology
To cite this article: Mertens J, Stock S, Lüngen M, Berg AV, Krämer U, Filipiak‐Pittroff B, Heinrich J, Koletzko S, Grübl A, Wichmann H‐E, Bauer C‐P, Reinhardt D, Berdel D, Gerber A. Is Prevention of Atopic Eczema with Hydrolyzed Formulas Cost‐Effective? A Health Economic Evaluation from Germany. Pediatr Allergy Immunol 2012: 23 : 597–604. Abstract Objective: The German Infant Nutritional Intervention (GINI) trial, a prospective, randomized, double‐blind intervention, enrolled children with a hereditary risk for atopy. When fed with certain hydrolyzed formulas for the first 4 months of life, the risk was reduced by 26–45% in PP and 8–29% in intention‐to‐treat (ITT) analyses compared with children fed with regular cow’s milk at age 6. The objective was to assess the cost‐effectiveness of feeding hydrolyzed formulas. Patients and Methods: Cost‐effectiveness was assessed with a decision tree model programmed in TreeAge. Costs and effects over a 6‐yr period were analyzed from the perspective of the German statutory health insurance (SHI) and a societal perspective at a 3% effective discount rate followed by sensitivity analyses. Results: The extensively hydrolyzed casein formula would be the most cost‐saving strategy with savings of 478 € per child treated in the ITT analysis (CI95%: 12 €; 852 €) and 979 € in the PP analysis (95%CI: 355 €; 1455 €) from a societal perspective. If prevented cases are considered, the partially whey hydrolyzed formula is cost‐saving (ITT ‐5404 €, PP ‐6358 €). From an SHI perspective, the partially whey hydrolyzed formula is cost‐effective, but may also be cost‐saving depending on the scenario. An extensively hydrolyzed whey formula also included into the analysis was dominated in all analyses. Conclusions: For the prevention of AE, two formulas can be cost‐effective or even cost‐saving. We recommend that SHI should reimburse formula feeding or at least the difference between costs for cow’s milk formula and the most cost‐effective formula.