Guest Julian F, Moya Fernando, Sisk Paula M, Hudak Mark L, Kuehn Devon
Catalyst Health Economics Consultants, Northwood, Middlesex, UK; Faculty of Life Sciences and Medicine, King's College, London, UK.
Coastal Carolina Neonatology, Wilmington, NC, USA.
Clinicoecon Outcomes Res. 2017 Jan 4;9:49-57. doi: 10.2147/CEOR.S122462. eCollection 2017.
To human milk fortifier (LHMF) compared to a powdered human milk fortifier (PHMF) in preterm infants in the US from the perspective of third-party payers and parents.
This was a decision modelling study using patient data obtained from a randomized controlled trial comparing a LHMF with a PHMF in preterm infants, supplemented with additional data obtained by performing a chart review among 79% of the trial patients. The model estimated the cost-effectiveness of LHMF versus PHMF in US$ at 2014/2015 prices.
More infants in the LHMF group were discharged home (92% versus 89%) and more infants in the PHMF group were transferred to another unit (9% versus 5%). Gestational age was an independent predictor for being discharged home (odds ratio of 2.18; =0.006 for each week of gestational age). Mean length of neonatal intensive care unit (NICU) stay was 1 day less in the LHMF than the PHMF group (62.3 versus 63.4 days), but mean length of NICU stay among infants who developed NEC or sepsis was 79.3 days and 61.2 days in the PHMF and LHMF groups, respectively. Total management cost up to discharge was $10,497 per infant less in the LHMF group than the PHMF group ($240,928 versus $251,425).
Using LHMF instead of PHMF in preterm infants enabled resources to be freed-up for alternative use within the system. There is no health economic reason why LHMF should not be used in preference to PHMF in the NICU.
从第三方支付方和家长的角度，比较美国早产儿使用液体人乳强化剂（LHMF）与粉状人乳强化剂（PHMF）的情况。
这是一项决策建模研究，使用从一项比较LHMF与PHMF对早产儿影响的随机对照试验中获取的患者数据，并补充了对79%的试验患者进行病历审查所获得的额外数据。该模型以2014/2015年的价格估算了LHMF与PHMF的成本效益（以美元计）。
LHMF组中更多婴儿出院回家（92%对89%），PHMF组中更多婴儿转至另一科室（9%对5%）。胎龄是出院回家的独立预测因素（比值比为2.18；胎龄每增加一周，P = 0.006）。LHMF组新生儿重症监护病房（NICU）的平均住院时间比PHMF组少1天（62.3天对63.4天），但发生坏死性小肠结肠炎（NEC）或败血症的婴儿中，PHMF组和LHMF组的NICU平均住院时间分别为79.3天和61.2天。至出院时，LHMF组每名婴儿的总管理成本比PHMF组少10,497美元（240,928美元对251,425美元）。
在早产儿中使用LHMF而非PHMF可在系统内腾出资源用于其他用途。在新生儿重症监护病房（NICU）中，没有健康经济学理由不优先使用LHMF而非PHMF。
