Berktas Mehmet, Kirbiyik Feza, Aribal Elif, Aksit Anil, Altintas Derya Ufuk
Blue Idea Consulting, London, UK.
Nutricia Advanced Medical Nutrition, Istanbul, Turkey.
Clinicoecon Outcomes Res. 2020 Jun 17;12:307-315. doi: 10.2147/CEOR.S242021. eCollection 2020.
Cow's milk protein allergy (CMPA) is one of the most common food allergies in early childhood. We aimed to evaluate clinical and economic outcomes of the amino-acid formula (AAF) and extensively hydrolyzed formula (eHF) based treatment of CMPA by using data available from Turkey and otherwise from literature.
A theoretical model was developed to evaluate AAF and eHF for CMPA treatment in terms of the number of children tolerating formula or experiencing an allergic reaction or withdrawing formula due to taste or other palatability features and CMPA related direct medical costs from the payer perspective.
We estimated that 13,000 children are diagnosed with CMPA in 1 year in Turkey. For the children receiving AAF, it is estimated that 83.7% tolerate AAF until the 24th month, and the total cost for the children tolerating AAF is estimated at 20.6 million€. The average cost per child tolerating AAF until the 24th month is estimated at 1895€. On the other hand, 48.7% are estimated to tolerate eHF until the 24th month, and the total cost for the children tolerating eHF is estimated at 12.3 million€ and the average cost per child tolerating eHF until the 24th month is estimated at 1940€.
The analysis revealed that the management of CMPA is associated with the economic burden on the healthcare system in Turkey. Treatment of CMPA with AAF seems to provide better clinical outcomes (high tolerability and less withdrawal due to taste or an allergic reaction) and to be an option with economic benefits when Turkey-specific conditions are considered.
牛奶蛋白过敏(CMPA)是幼儿期最常见的食物过敏之一。我们旨在利用土耳其的现有数据以及其他文献数据,评估基于氨基酸配方奶粉(AAF)和深度水解配方奶粉(eHF)治疗CMPA的临床和经济结果。
建立了一个理论模型,从支付方的角度,根据能够耐受配方奶粉、因过敏反应或因口味或其他适口性特征而停用配方奶粉的儿童数量以及与CMPA相关的直接医疗费用,来评估用于CMPA治疗的AAF和eHF。
我们估计,土耳其每年有13000名儿童被诊断为CMPA。对于接受AAF的儿童,估计83.7%的儿童在24个月时能耐受AAF,耐受AAF的儿童的总费用估计为2060万欧元。到24个月时,每个耐受AAF的儿童的平均费用估计为1895欧元。另一方面,估计48.7%的儿童在24个月时能耐受eHF,耐受eHF的儿童的总费用估计为1230万欧元,到24个月时,每个耐受eHF的儿童的平均费用估计为1940欧元。
分析表明,CMPA的管理与土耳其医疗保健系统的经济负担相关。考虑到土耳其的具体情况,用AAF治疗CMPA似乎能提供更好的临床结果(高耐受性以及因口味或过敏反应导致的停用较少),并且是一个具有经济效益的选择。