Nestlé Nutrition Institute, Avenue Reller 22, Vevey, Switzerland.
Ann Nutr Metab. 2011;59 Suppl 1:44-52. doi: 10.1159/000334232. Epub 2011 Dec 21.
Clinical trials have demonstrated that the risk of developing atopic dermatitis is reduced when using hydrolysed formulas to feed infants with a documented risk of atopy (i.e. an affected parent and/or sibling)when breastfeeding is not practised. However, little is known about the cost-effectiveness of using hydrolysed formulas. Consequently, economic analyses in 5 European countries (Denmark, France, Germany, Spain and Switzerland) have evaluated the costs and cost-effectiveness of a specific brand of 100% whey-based partially hydrolysed infant formula, NAN-HA® (PHF-W) compared with a cow's milk standard formula (SF) in the prevention of atopic dermatitis in at-risk children. This review synthesises the findings of these studies. Cost-effectiveness analyses (CEA) used a decision-analytic model to determine treatment pathways, resource utilisation and costs associated with the management of atopic dermatitis in healthy at-risk newborns who were not exclusively breastfed. The model had a 12-month horizon and applied reimbursement rates of 60-100% depending on the country. Outcomes were considered from the perspective of the public healthcare system (e.g. the Ministry of Health; MOH), family and society. The final outcome was the incremental cost-effectiveness ratio per avoided case of atopic dermatitis (ICER) for PHF-W versus SF. A cost-minimisation analysis was also performed to compare PHF-W with extensively hydrolysed formulas (EHF). The base-case CEA produced ICERs per avoided case for PHF-W versus SF of EUR 982-1,343 (MOH perspective), EUR -2,202 to -624 (family perspective) indicating savings, and EUR -1,220 to 719 from the societal perspective. The main costs related to formula (MOH and society) and time loss (family). In the cost-minimisation analysis, PHF-W yielded savings of between EUR 4.3 and 120 million compared with EHF-whey when the latter was used in prevention. In conclusion, PHF-W was cost-effective versus SF in the prevention of atopic dermatitis and cost saving compared with EHF when used in prevention.
临床研究表明，对于有特应性疾病家族史（即父母或兄弟姐妹中有特应性疾病患者）的婴儿，如果不进行母乳喂养，使用水解配方奶粉喂养可以降低特应性皮炎的发病风险。然而，目前对于使用水解配方奶粉的成本效益知之甚少。因此，在 5 个欧洲国家（丹麦、法国、德国、西班牙和瑞士）进行了经济分析，评估了一种特定品牌的 100%乳清蛋白部分水解婴儿配方奶粉 NAN-HA®（PHF-W）与牛奶标准配方（SF）在预防特应性疾病方面的成本效益，比较了在有风险的儿童中预防特应性皮炎的成本效益。这篇综述综合了这些研究的结果。成本效益分析（CEA）使用决策分析模型来确定治疗途径、资源利用和与非母乳喂养的健康有风险的新生儿特应性皮炎管理相关的成本。该模型的时间范围为 12 个月，应用的报销率为 60-100%，具体取决于国家。结果从公共医疗保健系统（例如卫生部；MOH）、家庭和社会的角度进行了考虑。最终结果是 PHF-W 与 SF 相比，每避免一例特应性皮炎的增量成本效益比（ICER）。还进行了成本最小化分析，以比较 PHF-W 与广泛水解配方（EHF）。基本情况 CEA 产生的 PHF-W 与 SF 相比，每避免一例特应性皮炎的 ICER 为 982-1343 欧元（MOH 角度）、-2202 至-624 欧元（家庭角度），表明有节约，从社会角度看，节约了 1220-719 欧元。主要成本与配方（MOH 和社会）和时间损失（家庭）有关。在成本最小化分析中，与 EHF 相比，当后者用于预防时，PHF-W 与 EHF 乳清相比，可节省 430 万至 1.2 亿欧元。总之，PHF-W 预防特应性皮炎的成本效益优于 SF，与 EHF 相比，在预防时具有成本效益。
