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Review
. 2019 Sep 14;19(1):337.
doi: 10.1186/s12887-019-1691-4.

An economic analysis of human milk supplementation for very low birth weight babies in the USA

Grace Hampson  1 , Sarah Louise Elin Roberts  2 , Alan Lucas  3 , David Parkin  4
Affiliations
Review

An economic analysis of human milk supplementation for very low birth weight babies in the USA

Grace Hampson et al. BMC Pediatr. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Cost-effectiveness; Economics; Exclusive human milk diet; Infants; Nutrition; Preterm.

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Conflict of interest statement

Grace Hampson is an employee of the Office of Health Economics, a registered charity, which receives funding from a variety of sources, including the Association of the British Pharmaceutical Industry. Alan Lucas has undertaken consultancy work for Prolacta Bioscience and other companies.

Figures

Fig. 1
Fig. 1
Diagram of model. Notes: Babies can also die during the initial hospital stay. For simplicity, this is not shown in the diagram; †short bowel syndrome is only a possibility for babies who have undergone surgical necrotising enterocolitis treatment; ‡reduction in IQ is applied to babies with necrotising enterocolitis and/or late onset sepsis only (costs to the health care system are limited, thus costs are only included in sensitivity analysis where we consider the societal perspective)
Fig. 2
Fig. 2
Incremental cost savings (per infant) from using an EHMD compared to usual practice of care, according to the incidence of NEC under usual practice of care
Fig. 3
Fig. 3
Results of sensitivity analyses
See this image and copyright information in PMC

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