Office of Health Economics, 7th Floor, Southside, 105 Victoria St, London, SW1E 6QT, UK.
King's College London, London, UK.
BMC Pediatr. 2019 Sep 14;19(1):337. doi: 10.1186/s12887-019-1691-4.
An exclusive human milk diet (EHMD) using human milk based products (pre-term formula and fortifiers) has been shown to lead to significant clinical benefits for very low birth weight (VLBW) babies (below 1250 g). This is expensive relative to diets that include cow's milk based products, but preliminary economic analyses have shown that the costs are more than offset by a reduction in the cost of neonatal care. However, these economic analyses have not completely assessed the economic implications of EHMD feeding, as they have not considered the range of outcomes affected by it.
We conducted an economic analysis of EHMD compared to usual practice of care amongst VLBW babies in the US, which is to include cow's milk based products when required. Costs were evaluated from the perspective of the health care payer, with societal costs considered in sensitivity analyses.
An EHMD substantially reduces mortality and improves other health outcomes, as well as generating substantial cost savings of $16,309 per infant by reducing adverse clinical events. Cost savings increase to $117,239 per infant when wider societal costs are included.
An EHMD is dominant in cost-effectiveness terms, that is it is both cost-saving and clinically beneficial, for VLBW babies in a US-based setting.
使用基于人乳的产品（早产儿配方和强化剂）的人乳专食（EHMD）已被证明可为人均出生体重低于 1250 克的极低出生体重（VLBW）婴儿带来显著的临床获益。相较于包含牛乳基产品的饮食，EHMD 更昂贵，但初步的经济分析表明，新生儿护理成本的降低足以抵消费用的增加。然而，这些经济分析并未完全评估 EHMD 喂养的经济影响，因为它们没有考虑到受其影响的各种结果。
我们在美国的 VLBW 婴儿中进行了 EHMD 与常规护理相比的经济分析，即需要时包含牛乳基产品。从医疗保健支付者的角度评估了成本，并在敏感性分析中考虑了社会成本。
EHMD 可大幅降低死亡率并改善其他健康结果，并通过减少不良临床事件，每例婴儿可节省 16309 美元的成本。当纳入更广泛的社会成本时，每例婴儿的节省成本增加至 117239 美元。
对于美国的 VLBW 婴儿，EHMD 在成本效益方面具有优势，即它不仅节省成本，而且在临床方面有益。
