Cost-ffectiveness of Supplemental Donor Milk Versus Formula for Very Low Birth Weight Infants

被引:48
作者
Trang, Susan [1 ,4 ]
Zupancic, John A. F. [5 ]
Unger, Sharon [2 ,6 ]
Kiss, Alex [3 ,7 ]
Bando, Nicole [4 ]
Wong, Sabrina [8 ]
Gibbins, Sharyn [9 ]
O'Connor, Deborah L. [1 ,4 ,6 ]
机构
[1] Univ Toronto, Dept Nutr Sci, Room 327,Fitzgerald Bldg,150 Coll St, Toronto, ON M5S 3E2, Canada
[2] Univ Toronto, Dept Pediat, Toronto, ON, Canada
[3] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[4] Hosp Sick Children, Translat Med Program, Toronto, ON, Canada
[5] Beth Israel Deaconess Med Ctr, Dept Neonatol, Boston, MA 02215 USA
[6] Mt Sinai Hosp, Dept Paediat, Toronto, ON, Canada
[7] Sunnybrook Hlth Sci Ctr, Evaluat Clin Sci, Toronto, ON, Canada
[8] Sunnybrook Hlth Sci Ctr, Neonatol, Toronto, ON, Canada
[9] Trillium Hlth Partners, Mississauga, ON, Canada
基金
加拿大健康研究院;
关键词
EFFECTIVENESS ACCEPTABILITY CURVES; PROSPECTIVE ECONOMIC-EVALUATION; EXTREMELY PREMATURE-INFANTS; INTENSIVE-CARE-UNIT; NECROTIZING ENTEROCOLITIS; PRETERM FORMULA; BREAST-MILK; TRIAL; ALONGSIDE; OUTCOMES;
D O I
10.1542/peds.2017-0737
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVES: To determine the cost-effectiveness of supplemental donor human milk (DHM) versus preterm formula (PTF) for very low birth weight (VLBW, <1500 g) infants from a societal perspective to 18 months' corrected age. METHODS: This prospective cost-effectiveness analysis of 363 VLBW infants was conducted for a randomized control trial. Infants recruited from October 2010 to December 2012 were fed DHM or PTF whenever mother's milk was unavailable. Formal health care costs for initial hospitalization and readmissions were obtained from standardized cost-accounting systems and physician fees. Informal and nonhealth care sector costs (eg, caregiver transportation, labor market earnings) were calculated from parent reports. RESULTS: Mean infant birth weight was 996 (SD, 272) grams. Incidence of necrotizing enterocolitis (NEC) differed between groups (all stages 3.9% DHM, 11.0% PTF; P =.01). Costs to 18 months did not differ with a mean (95% confidence interval) of 217 624 (197 697-237 551) and 217 245 (196 494-237 995) 2015 Canadian dollars in the DHM and PTF groups. Postdischarge costs were lower in the DHM (46 440 [40 648-52 233]) than PTF group (55 102 [48 269-61 934]) (P =.04), driven by parent lost wages. DHM cost an additional $5328 per case of averted NEC. CONCLUSIONS: In a high mother's milk use setting, total costs from a societal perspective to 18 months of providing supplemental DHM versus PTF to VLBW infants did not differ, although postdischarge costs were lower in the DHM group. Although supplemental DHM was not cost-saving, it reduced NEC supporting its use over PTF.
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页数:10
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