Economic value of atopic dermatitis prevention via partially-hydrolyzed whey-based infant formula (PHF-W) use in high-risk, non-exclusively breastfed, Indonesian urban infants: results of a cost-effectiveness model

Abstract

Background: Early nutritional intervention with partially-hydrolyzed whey-based formula (PHF-W) instead of standard cow’s milk formula (CMF) has been found to reduce the risk of atopic dermatitis (AD) development in non-exclusively breastfed infants with familial heredity of AD.Objective: To estimate the 6-year economic impact of this nutritional intervention in non-exclusively breastfed Indonesian urban infants with family history of AD.Methods: A mathematical model simulated AD incidence and burden of using PHF-W vs. CMF in the target population from birth to age 6. The model integrated literature, current cost and market catalogues, and expert clinician opinion. Modeled outcomes included AD risk, time spent post-AD diagnosis, days without flare, quality-adjusted life-years, and costs.Results: Using PHF-W instead of CMF resulted in an estimated absolute 14% (95% CI: 4%, 23%) AD risk reduction, a 0.69 year (95% CI: 0.26, 1.13) per-child reduction in time spent post-AD diagnosis, a 38 (95% CI: 12, 67) increase in days without AD flare, and a 0.046 gain in quality-adjusted life-years. The AD-related 6-year cost estimates when feeding high-risk urban infants with PHF-W were Indonesian Rupiah (IDR) 8,695,057 (95% CI: IDR 4,519,447, IDR13,995,605) and IDR13,139,569 (95% CI: IDR 7,098,794, IDR 19,216,068) per child, respectively, resulting in a net per-child difference of IDR 4,444,512 (95% CI: IDR1,893,080, IDR 8,557,946) favoring PHF-W.Conclusion: PHF-W for the first 17 weeks of non-exclusively breastfed Indonesian urban infants with a hereditary risk of AD demonstrated a reduction in AD incidence, increased days without flare, and increased quality-adjusted life-years and net cost reductions.

A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants

“…An Indonesian health economic study by Botteman et al [22] found that the use of 100% pHF-W in high-risk infants over the 6-year follow-up period would save cost up to IDR 35 million. Besides, the use of 100% pHF-W would lead to a 14% reduction in AD risk among high-risk infants.…”

Perspective of Caesarean section delivery and its health risks on children among Indonesian pediatricians

“…13,23,24 The aspect of cost-effectiveness and health economics review should also need to be taken into account when it comes to nutrition intervention. 25,26 Therefore the perspective of respondents of this study toward synbiotic with the partial hydrolyzed milk to infants born via C-section is evidence-based and rational with existing studies.…”

The Role of Obstetrician in Reducing the Risks of Childhood Allergy Related to Cesarean Birth: A Literature Review

“…58 Economic burden of C-section born babies were also other health related indicator that need to be consider as points to be further discuss and analyzed in the future researches and reviews. 59,60 We acknowledge that there are limitations to this review. The knowledge and competency development among birth attendants, including midwives and obstetric gynecologist are points that need to be thoroughly reviewed in order to get the full perspective on how medical practitioners could also plays role in mother's decision making on delivery mode.…”