Department of Dermatology, Royal Children's Hospital, University of Melbourne, Melbourne, Australia; Monash University, Melbourne, Australia.
J Med Econ. 2012;15(6):1064-77. doi: 10.3111/13696998.2012.697085. Epub 2012 Jun 12.
To perform an economic evaluation of a specific brand of partially hydrolyzed infant formula (PHF-W) in the prevention of atopic dermatitis (AD) among Australian infants.
A cost-effectiveness analysis was undertaken from the perspectives of the Department of Health and Aging (DHA), of the family of the affected subject and of society as a whole in Australia, based on a decision-analytic model following a hypothetical representative cohort of Australian newborns who are not exclusively breastfed and who have a familial history of allergic disease (i.e., are deemed 'at risk'). Costs, consequences, and incremental cost-effectiveness ratios (ICER) were calculated for PHF-W vs standard cow's milk based infant formula (SF), and, in a secondary analysis, vs extensively hydrolyzed infant formula (EHF-Whey), when the latter was used for the prevention of AD.
From a representative starting cohort of 87,724 'at risk' newborns in Australia in 2009, the expected ICERs for PHF-W vs SF were AU$496 from the perspective of the DHA and savings of AUD1739 and AU$1243 from the family and societal perspectives, respectively. When compared to EHF-Whey, PHF-W was associated with savings for the cohort of AU$5,183,474 and AU$6,736,513 from the DHA and societal perspectives.
The generalizability and transferability of results to other settings, populations, or brands of infant formula should be made with caution. Whenever possible, a conservative approach directing bias against PHF-W rather than its comparators was applied in the base case analysis. Assumptions were verified in one-way and probabilistic sensitivity analyses, which confirmed the robustness of the model.
PHF-W appears to be cost-effective when compared to SF from the DHA perspective, dominant over SF from the other perspectives, and dominant over EHF-Whey from all perspectives, in the prevention of AD in 'at risk' infants not exclusively breastfed, in Australia.
对一种特定品牌的部分水解婴儿配方奶粉（PHF-W）进行经济评估，以预防澳大利亚婴儿特应性皮炎（AD）。
从澳大利亚卫生部和老龄化部（DHA）、受影响个体家庭以及整个社会的角度，基于一个假设的代表性澳大利亚新生儿队列进行成本效益分析，该队列新生儿未进行纯母乳喂养且具有过敏疾病家族史（即，被认为“有风险”）。对于 PHF-W 与标准牛奶基婴儿配方奶粉（SF），以及在后者用于预防 AD 时与高度水解婴儿配方奶粉（EHF-Whey），计算 PHF-W 的成本、后果和增量成本效益比（ICER）。
从澳大利亚 2009 年 87724 名“有风险”新生儿的代表性起始队列来看，DHA 认为 PHF-W 与 SF 相比的预期 ICER 为 496 澳元，家庭和社会的观点分别节省 1739 澳元和 1243 澳元。与 EHF-Whey 相比，PHF-W 使队列节省 5183474 澳元和 6736513 澳元，从 DHA 和社会角度来看。
结果在其他环境、人群或婴儿配方奶粉品牌中的推广和转移应谨慎进行。在基础案例分析中，只要有可能，就采用一种保守的方法，使 PHF-W 而不是其对照物产生偏差。通过单向和概率敏感性分析验证了假设，这些分析证实了模型的稳健性。
在预防澳大利亚非纯母乳喂养“有风险”婴儿 AD 方面，PHF-W 与 SF 相比从 DHA 角度来看具有成本效益，从其他角度来看具有优势，与 EHF-Whey 相比在所有角度均具有优势。
