Is prevention of atopic eczema with hydrolyzed formulas cost-effective? A health economic evaluation from Germany |
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| Authors: | Mertens Janina Stock Stephanie Lüngen Markus V Berg Andrea Kr?mer Ursula Filipiak-Pittroff Birgit Heinrich Joachim Koletzko Sibylle Grübl Armin Wichmann H-Erich Bauer Carl-P Reinhardt Dietrich Berdel Dietrich Gerber Andreas |
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| Institution: | Institut für Gesundheits?konomie und Klinische Epidemiologie (IGKE), Cologne University, Cologne, Germany Department of Paediatrics, Research Institute, Marien-Hospital Wesel, Wesel, Germany Leibnis Research Institute for Environmental Medicine at the Heinrich- Heine- University, Düsseldorf, Germany Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany Ludwig-Maximilians-University, Dr von Haunersches Kinderspital, Munich, Germany Department of Pediatrics, Technical University of Munich, Munich, Germany LVA Oberbayern, Munich, Germany Ludwig-Maximilians-University, Institute of Medical Data Management, Biometrics and Epidemiology, Chair of Epidemiology, Munich, Germany Institut für Qualit?t und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Cologne, Germany Chair of Health Economics , Department of Economics and Social Sciences, Hochschule Osnabrück, Osnabrück. |
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| Abstract: | To cite this article: Mertens J, Stock S, Lüngen M, Berg AV, Kr?mer 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. |
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