An exclusive human milk diet for very low birth weight newborns-A cost-effectiveness and EVPI study for Germany.
<h4>Objectives</h4>Human milk-based fortifiers have shown a protective effect on major complications for very low birth weight newborns. The current study aimed to estimate the cost-effectiveness of an exclusive human milk diet (EHMD) compared to the current approach using cow's mil...
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226496&type=printable |
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| author | Stefan Michael Scholz Wolfgang Greiner |
| author_facet | Stefan Michael Scholz Wolfgang Greiner |
| author_sort | Stefan Michael Scholz |
| collection | DOAJ |
| description | <h4>Objectives</h4>Human milk-based fortifiers have shown a protective effect on major complications for very low birth weight newborns. The current study aimed to estimate the cost-effectiveness of an exclusive human milk diet (EHMD) compared to the current approach using cow's milk-based fortifiers in very low birth weight newborns.<h4>Methods</h4>A decision tree model using the health states of necrotising enterocolitis (NEC), sepsis, NEC + sepsis and no complication was used to calculate the cost-effectiveness of an EHMD. For each health state, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (RoP) and neurodevelopmental problems were included as possible complications; additionally, short-bowel syndrome (SBS) was included as a complication for surgical treatment of NEC. The model was stratified into birth weight categories. Costs for inpatient treatment and long-term consequences were considered from a third party payer perspective for the reference year 2017. Deterministic and probabilistic sensitivity analyses were performed, including a societal perspective, discounting rate and all input parameter-values.<h4>Results</h4>In the base case, the EHMD was estimated to be cost-effective compared to the current nutrition for very low birth weight newborns with an incremental cost-effectiveness ratio (ICER) of €28,325 per Life-Year-Gained (LYG). From a societal perspective, the ICER is €27,494/LYG using a friction cost approach and €16,112/LYG using a human capital approach. Deterministic sensitivity analyses demonstrated that the estimate was robust against changes in the input parameters and probabilistic sensitivity analysis suggested that the probability EHMD was cost-effective at a threshold of €45,790/LYG was 94.8 percent.<h4>Conclusion</h4>Adopting EHMD as the standard approach to nutrition is a cost-effective intervention for very low birth weight newborns in Germany. |
| format | Article |
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| issn | 1932-6203 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-4430e90a9e174c52836f53fbd893e08a2025-08-20T02:00:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011412e022649610.1371/journal.pone.0226496An exclusive human milk diet for very low birth weight newborns-A cost-effectiveness and EVPI study for Germany.Stefan Michael ScholzWolfgang Greiner<h4>Objectives</h4>Human milk-based fortifiers have shown a protective effect on major complications for very low birth weight newborns. The current study aimed to estimate the cost-effectiveness of an exclusive human milk diet (EHMD) compared to the current approach using cow's milk-based fortifiers in very low birth weight newborns.<h4>Methods</h4>A decision tree model using the health states of necrotising enterocolitis (NEC), sepsis, NEC + sepsis and no complication was used to calculate the cost-effectiveness of an EHMD. For each health state, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (RoP) and neurodevelopmental problems were included as possible complications; additionally, short-bowel syndrome (SBS) was included as a complication for surgical treatment of NEC. The model was stratified into birth weight categories. Costs for inpatient treatment and long-term consequences were considered from a third party payer perspective for the reference year 2017. Deterministic and probabilistic sensitivity analyses were performed, including a societal perspective, discounting rate and all input parameter-values.<h4>Results</h4>In the base case, the EHMD was estimated to be cost-effective compared to the current nutrition for very low birth weight newborns with an incremental cost-effectiveness ratio (ICER) of €28,325 per Life-Year-Gained (LYG). From a societal perspective, the ICER is €27,494/LYG using a friction cost approach and €16,112/LYG using a human capital approach. Deterministic sensitivity analyses demonstrated that the estimate was robust against changes in the input parameters and probabilistic sensitivity analysis suggested that the probability EHMD was cost-effective at a threshold of €45,790/LYG was 94.8 percent.<h4>Conclusion</h4>Adopting EHMD as the standard approach to nutrition is a cost-effective intervention for very low birth weight newborns in Germany.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226496&type=printable |
| spellingShingle | Stefan Michael Scholz Wolfgang Greiner An exclusive human milk diet for very low birth weight newborns-A cost-effectiveness and EVPI study for Germany. PLoS ONE |
| title | An exclusive human milk diet for very low birth weight newborns-A cost-effectiveness and EVPI study for Germany. |
| title_full | An exclusive human milk diet for very low birth weight newborns-A cost-effectiveness and EVPI study for Germany. |
| title_fullStr | An exclusive human milk diet for very low birth weight newborns-A cost-effectiveness and EVPI study for Germany. |
| title_full_unstemmed | An exclusive human milk diet for very low birth weight newborns-A cost-effectiveness and EVPI study for Germany. |
| title_short | An exclusive human milk diet for very low birth weight newborns-A cost-effectiveness and EVPI study for Germany. |
| title_sort | exclusive human milk diet for very low birth weight newborns a cost effectiveness and evpi study for germany |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226496&type=printable |
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