Cost-effectiveness of infant hypoallergenic formulas to manage cow's milk protein allergy in France

• Published in: Journal of market access & health policy Vol. 11; no. 1; p. 2154418
• Main Authors: Paquete, Ana Teresa, Martins, Rui, Connolly, Mark P., Meulle, Marie, Pastor, Nítida, Benoist, Grégoire, Tounian, Patrick
• Format: Journal Article
• Language: English
• Published: United States Routledge 2023; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Babies; Breastfeeding & lactation; child nutrition sciences; Children; Childrens health; Cost analysis; Cost control; Cost-effectiveness analysis; Cow's milk protein allergy; Decision making; Effectiveness; Food allergies; France; Health care expenditures; Health care industry; Health care policy; Health economics; Infants; Milk; milk substitutes; National health insurance; Nutrition; Original; Proteins; Tolerance; France; Cost-effectiveness analysis; Cow’s milk protein allergy; France; child nutrition sciences; milk substitutes
• ISSN: 2001-6689; 2001-6689
• DOI: 10.1080/20016689.2022.2154418

Clinician's choice of hypoallergenic formulas in the first-line management of cow's milk protein allergy (CMPA) should be informed by evidence on clinical efficacy and cost-effectiveness.
We compare the cost-effectiveness of amino acid-based formula (AAF), extensively hydrolyzed casein formula with Lactobacillus rhamnosus Gorbach Goldin (EHCF+LGG), extensively hydrolyzed whey formula (EHWF), and rice hydrolyzed formula (RHF) in non-breastfed children in France.
Immunotolerance and atopic manifestations' prevalence were based on a prospective non-randomized study with a 36-month follow-up. Resource utilization was sourced from a survey of French clinicians, and unit costs were based on national data. Costs and health consequences were discounted at 2.5% annually. Results were reported using the Collective and French National Health Insurance perspectives.
Children receiving EHCF+LGG were predicted to require less healthcare resources, given their reduced prevalence of CMPA symptoms at 3 years. In the base case, EHCF+LGG led to savings of at least €674 per child compared to AAF, EHWF, and RHF at 3 years, from both perspectives. Nutrition had the highest economic burden in CMPA, driven by hypoallergenic formulas and dietetic replacements costs. Results were robust to one-way and probabilistic sensitivity analyses.
EHCF+LGG was associated with more symptom-free time, higher immune tolerance, and lower costs.