Economic value of atopic dermatitis prevention via infant formula use in high-risk Malaysian infants
10.5415/apallergy.2015.5.2.84
- Author:
Abhijeet J BHANEGAONKAR
1
;
Erica G HORODNICEANU
;
Amir Hamzah ABDUL LATIFF
;
Sanjay WOODHULL
;
Phaik Choo KHOO
;
Patrick DETZEL
;
Xiang JI
;
Marc F BOTTEMAN
Author Information
1. Pharmerit International, Bethesda, MD 20814, USA. mbotteman@pharmerit.com
- Publication Type:Original Article
- Keywords:
Cost-benefit analysis;
Dermatitis atopic;
Infant formula
- MeSH:
Breast Feeding;
Cohort Studies;
Cost-Benefit Analysis;
Dermatitis, Atopic;
Diagnosis;
Expert Testimony;
Health Services Needs and Demand;
Humans;
Incidence;
Income;
Infant Formula;
Infant;
Milk;
Parturition;
Quality-Adjusted Life Years;
Risk Reduction Behavior;
United States;
World Health Organization
- From:
Asia Pacific Allergy
2015;5(2):84-97
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Breastfeeding is best for infants and the World Health Organization recommends exclusive breastfeeding for at least the first 6 months of life. For those who are unable to be breastfed, previous studies demonstrate that feeding high-risk infants with hydrolyzed formulas instead of cow's milk formula (CMF) may decrease the risk of atopic dermatitis (AD). OBJECTIVE: To estimate the economic impact of feeding high-risk, not exclusively breastfed, urban Malaysian infants with partiallyhydrolyzed whey-based formula (PHF-W) instead of CMF for the first 17 weeks of life as an AD risk reduction strategy. METHODS: A cohort Markov model simulated the AD incidence and burden from birth to age 6 years in the target population fed with PHF-W vs. CMF. The model integrated published clinical and epidemiologic data, local cost data, and expert opinion. Modeled outcomes included AD-risk reduction, time spent post AD diagnosis, days without AD flare, quality-adjusted life years (QALYs), and costs (direct and indirect). Outcomes were discounted at 3% per year. Costs are expressed in Malaysian Ringgit (MYR; MYR 1,000 = United States dollar [US $]316.50). RESULTS: Feeding a high-risk infant PHF-W vs. CMF resulted in a 14% point reduction in AD risk (95% confidence interval [CI], 3%-23%), a 0.69-year (95% CI, 0.25-1.10) reduction in time spent post-AD diagnosis, additional 38 (95% CI, 2-94) days without AD flare, and an undiscounted gain of 0.041 (95% CI, 0.007-0.103) QALYs. The discounted AD-related 6-year cost estimates when feeding a high-risk infant with PHF-W were MYR 1,758 (US $556) (95% CI, MYR 917-3,033) and with CMF MYR 2,871 (US $909) (95% CI, MYR 1,697-4,278), resulting in a per-child net saving of MYR 1,113 (US $352) (95% CI, MYR 317-1,884) favoring PHF-W. CONCLUSION: Using PHF-W instead of CMF in this population is expected to result in AD-related costs savings.
