Limits...
Relative cost-effectiveness of using an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG in managing infants with cow's milk allergy in Spain.

Guest JF, Weidlich D, Mascuñan Díaz JI, Díaz JJ, Ojeda PM, Ferrer-González JP, Gil D, Onrubia I, Rincón Victor P - Clinicoecon Outcomes Res (2015)

Bottom Line: The models also estimated the SNS cost (at 2012/2013 prices) of managing infants over 18 months after starting a formula as well as the relative cost-effectiveness of each of the formulae.The total health care cost of initially feeding infants with eHCF + LGG was less than that of feeding infants with one of the other formulae.A randomized controlled study showing faster tolerance development in children receiving a probiotic-containing formula is required before this conclusion can be confirmed.

View Article: PubMed Central - PubMed

Affiliation: Catalyst Health Economics Consultants, Northwood, Middlesex, UK ; Faculty of Life Sciences and Medicine, King's College, London, UK.

ABSTRACT

Objective: To estimate the cost-effectiveness of using an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG (eHCF + LGG; Nutramigen LGG) as a first-line management for cow's milk allergy compared with eHCF alone, and amino acid formulae in Spain, from the perspective of the Spanish National Health Service (SNS).

Methods: Decision modeling was used to estimate the probability of immunoglobulin E (IgE)-mediated and non-IgE-mediated allergic infants developing tolerance to cow's milk by 18 months. The models also estimated the SNS cost (at 2012/2013 prices) of managing infants over 18 months after starting a formula as well as the relative cost-effectiveness of each of the formulae.

Results: The probability of developing tolerance to cow's milk by 18 months was higher among infants with either IgE-mediated or non-IgE-mediated allergy who were fed eHCF + LGG compared with those fed one of the other formulae. The total health care cost of initially feeding infants with eHCF + LGG was less than that of feeding infants with one of the other formulae. Hence, eHCF + LGG affords the greatest value for money to the SNS for managing both IgE-mediated and non-IgE-mediated cow's milk allergy.

Conclusion: Using eHCF + LGG instead of eHCF alone or amino acid formulae for first-line management of newly-diagnosed infants with cow's milk allergy affords a cost-effective use of publicly funded resources because it improves outcome for less cost. A randomized controlled study showing faster tolerance development in children receiving a probiotic-containing formula is required before this conclusion can be confirmed.

No MeSH data available.


Related in: MedlinePlus

(A) Distribution of expected SNS costs over 18 months from starting a formula and expected probability of developing tolerance to cow’s milk by 18 months among IgE-mediated allergic infants, generated by 10,000 iterations of the model. (B) Distribution of expected SNS costs over 18 months from starting a formula and expected probability of developing tolerance to cow’s milk by 18 months among non–IgE-mediated allergic infants, generated by 10,000 iterations of the model.Abbreviations: AAF, amino acid formulae; eHCF, extensively hydrolyzed casein formula; IgE, immunoglobulin E; LGG, Lactobacillus rhamnosus GG; SNS, Spanish National Health Service.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4664436&req=5

f2-ceor-7-583: (A) Distribution of expected SNS costs over 18 months from starting a formula and expected probability of developing tolerance to cow’s milk by 18 months among IgE-mediated allergic infants, generated by 10,000 iterations of the model. (B) Distribution of expected SNS costs over 18 months from starting a formula and expected probability of developing tolerance to cow’s milk by 18 months among non–IgE-mediated allergic infants, generated by 10,000 iterations of the model.Abbreviations: AAF, amino acid formulae; eHCF, extensively hydrolyzed casein formula; IgE, immunoglobulin E; LGG, Lactobacillus rhamnosus GG; SNS, Spanish National Health Service.

Mentions: Probabilistic sensitivity analyses were performed to estimate the distribution of expected SNS costs (Figure 2) over 18 months from starting a formula and probability of developing tolerance to cow’s milk by 18 months. Using these distributions, the probability of each formula being cost-effective at different cost-effectiveness thresholds was estimated (Figure 3). These graphs show that the probability of eHCF + LGG being cost-effective was greater than that with the other formulae for both IgE-mediated and non–IgE-mediated allergic infants, from the perspective of the SNS. Moreover, these graphs suggest that neither eHCF nor AAF would afford a cost-effective use of resources when compared with eHCF + LGG.


Relative cost-effectiveness of using an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG in managing infants with cow's milk allergy in Spain.

Guest JF, Weidlich D, Mascuñan Díaz JI, Díaz JJ, Ojeda PM, Ferrer-González JP, Gil D, Onrubia I, Rincón Victor P - Clinicoecon Outcomes Res (2015)

(A) Distribution of expected SNS costs over 18 months from starting a formula and expected probability of developing tolerance to cow’s milk by 18 months among IgE-mediated allergic infants, generated by 10,000 iterations of the model. (B) Distribution of expected SNS costs over 18 months from starting a formula and expected probability of developing tolerance to cow’s milk by 18 months among non–IgE-mediated allergic infants, generated by 10,000 iterations of the model.Abbreviations: AAF, amino acid formulae; eHCF, extensively hydrolyzed casein formula; IgE, immunoglobulin E; LGG, Lactobacillus rhamnosus GG; SNS, Spanish National Health Service.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664436&req=5

f2-ceor-7-583: (A) Distribution of expected SNS costs over 18 months from starting a formula and expected probability of developing tolerance to cow’s milk by 18 months among IgE-mediated allergic infants, generated by 10,000 iterations of the model. (B) Distribution of expected SNS costs over 18 months from starting a formula and expected probability of developing tolerance to cow’s milk by 18 months among non–IgE-mediated allergic infants, generated by 10,000 iterations of the model.Abbreviations: AAF, amino acid formulae; eHCF, extensively hydrolyzed casein formula; IgE, immunoglobulin E; LGG, Lactobacillus rhamnosus GG; SNS, Spanish National Health Service.
Mentions: Probabilistic sensitivity analyses were performed to estimate the distribution of expected SNS costs (Figure 2) over 18 months from starting a formula and probability of developing tolerance to cow’s milk by 18 months. Using these distributions, the probability of each formula being cost-effective at different cost-effectiveness thresholds was estimated (Figure 3). These graphs show that the probability of eHCF + LGG being cost-effective was greater than that with the other formulae for both IgE-mediated and non–IgE-mediated allergic infants, from the perspective of the SNS. Moreover, these graphs suggest that neither eHCF nor AAF would afford a cost-effective use of resources when compared with eHCF + LGG.

Bottom Line: The models also estimated the SNS cost (at 2012/2013 prices) of managing infants over 18 months after starting a formula as well as the relative cost-effectiveness of each of the formulae.The total health care cost of initially feeding infants with eHCF + LGG was less than that of feeding infants with one of the other formulae.A randomized controlled study showing faster tolerance development in children receiving a probiotic-containing formula is required before this conclusion can be confirmed.

View Article: PubMed Central - PubMed

Affiliation: Catalyst Health Economics Consultants, Northwood, Middlesex, UK ; Faculty of Life Sciences and Medicine, King's College, London, UK.

ABSTRACT

Objective: To estimate the cost-effectiveness of using an extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG (eHCF + LGG; Nutramigen LGG) as a first-line management for cow's milk allergy compared with eHCF alone, and amino acid formulae in Spain, from the perspective of the Spanish National Health Service (SNS).

Methods: Decision modeling was used to estimate the probability of immunoglobulin E (IgE)-mediated and non-IgE-mediated allergic infants developing tolerance to cow's milk by 18 months. The models also estimated the SNS cost (at 2012/2013 prices) of managing infants over 18 months after starting a formula as well as the relative cost-effectiveness of each of the formulae.

Results: The probability of developing tolerance to cow's milk by 18 months was higher among infants with either IgE-mediated or non-IgE-mediated allergy who were fed eHCF + LGG compared with those fed one of the other formulae. The total health care cost of initially feeding infants with eHCF + LGG was less than that of feeding infants with one of the other formulae. Hence, eHCF + LGG affords the greatest value for money to the SNS for managing both IgE-mediated and non-IgE-mediated cow's milk allergy.

Conclusion: Using eHCF + LGG instead of eHCF alone or amino acid formulae for first-line management of newly-diagnosed infants with cow's milk allergy affords a cost-effective use of publicly funded resources because it improves outcome for less cost. A randomized controlled study showing faster tolerance development in children receiving a probiotic-containing formula is required before this conclusion can be confirmed.

No MeSH data available.


Related in: MedlinePlus