PMID- 34430667
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231003
IS  - 2327-2236 (Electronic)
IS  - 2326-697X (Print)
IS  - 2326-697X (Linking)
VI  - 8
IP  - 2
DP  - 2021
TI  - Cost-effectiveness Analysis of Hypoallergenic Milk Formulas for the Management of 
      Cow's Milk Protein Allergy in the United Kingdom.
PG  - 14-25
LID - 10.36469/jheor.2021.26010 [doi]
AB  - Background: Cow's milk protein allergy (CMPA) is the most common food allergy in 
      early childhood. In most children CMPA resolves by age 5 or 6; however, if not 
      treated correctly can provoke nutritional deficiency resulting in poor growth. 
      Management consists of excluding cow's milk from the diet, with hypoallergenic 
      formulas (or non-dairy alternatives) being introduced to meet nutritional 
      requirements. Objectives: To compare the cost-effectiveness of hypoallergenic 
      formulas in reducing allergic manifestations and promoting immune tolerance in 
      infants with immunoglobulin E (IgE)-mediated symptoms of CMPA. Methods: A 
      trial-based decision analytic cohort model was developed to simulate the 
      occurrence of urticaria, eczema, asthma, rhinoconjunctivitis, or being 
      symptom-free in infants with CMPA in the United Kingdom. Amino acid-based formula 
      (AAF), extensively hydrolysed casein formula containing Lactobacillus rhamnosus 
      Gorbach Goldin (EHCF+LGG), extensively hydrolysed whey formula (EHWF), and soy 
      formula (SF) were compared using the National Health Service (NHS) perspective, 
      3-year time horizon and 3.5% discount rate for cost and health consequences. 
      Hypoallergenic formulas comparative efficacy was sourced from a prospective 
      cohort study. Resources required to manage allergic symptoms were sourced from 
      published literature, validated by a UK clinician, and applied to UK cost 
      resources. Results were reported as cost per additional child free from allergic 
      manifestations at 3 years and cost per additional immune tolerant child at 3 
      years. Results: In the base case, infants receiving EHCF+LGG were associated with 
      lower NHS resource use and improved CMPA tolerance. Over the 3-year treatment 
      period, savings of  pound119,  pound476, and  pound1094 were achieved with EHCF+LGG compared to 
      SF, EHWF and AAF, respectively. Infant formula accounted for the largest 
      proportion of resource consumption averaging 44% for all comparators, with a 
      minimum of 31% for SF and a maximum of 53% for AAF over 3 years. General 
      practitioners' visits constituted the second highest cost component, 
      approximately 17% of total costs across comparators. The results were robust to 
      deterministic and probabilistic sensitivity analyses. Conclusions: Compared to 
      AAF, SF, and EHWF hypoallergenic formulas, EHCF+LGG was the most cost-effective, 
      associated with lower total costs and contributing to a higher proportion of 
      children being symptom-free and developing immune tolerance 3-years after 
      diagnosis.
FAU - Martins, Rui
AU  - Martins R
AD  - Global Market Access Solutions, Health Economics Unit, St-Prex, Switzerland.
FAU - Connolly, Mark P
AU  - Connolly MP
AD  - Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, 
      University of Groningen, Groningen, The Netherlands; GMAS Services LTD, London, 
      England.
FAU - Minshall, Eleanor
AU  - Minshall E
AD  - Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom.
LA  - eng
PT  - Journal Article
DEP - 20210806
PL  - United States
TA  - J Health Econ Outcomes Res
JT  - Journal of health economics and outcomes research
JID - 101648581
EIN - J Health Econ Outcomes Res. 2021 Oct 6;8(2):63. PMID: 34703833
PMC - PMC8346363
OTO - NOTNLM
OT  - atopic march
OT  - cost-effectiveness
OT  - cow's milk protein allergy
OT  - hypoallergenic formula milk
EDAT- 2021/08/26 06:00
MHDA- 2021/08/26 06:01
PMCR- 2021/08/06
CRDT- 2021/08/25 06:28
PHST- 2021/06/16 00:00 [received]
PHST- 2021/07/19 00:00 [accepted]
PHST- 2021/08/25 06:28 [entrez]
PHST- 2021/08/26 06:00 [pubmed]
PHST- 2021/08/26 06:01 [medline]
PHST- 2021/08/06 00:00 [pmc-release]
AID - 26010 [pii]
AID - 10.36469/jheor.2021.26010 [doi]
PST - epublish
SO  - J Health Econ Outcomes Res. 2021 Aug 6;8(2):14-25. doi: 
      10.36469/jheor.2021.26010. eCollection 2021.