An exclusive human milk diet for very low birth weight newborns—A cost-effectiveness and EVPI study for Germany

Scholz S, Greiner W (2019)
PLOS ONE 14(12): e0226496.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
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Abstract / Bemerkung
Objectives 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. Methods 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. Results 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. Conclusion Adopting EHMD as the standard approach to nutrition is a cost-effective intervention for very low birth weight newborns in Germany.
Erscheinungsjahr
2019
Zeitschriftentitel
PLOS ONE
Band
14
Ausgabe
12
Art.-Nr.
e0226496
ISSN
1932-6203
eISSN
1932-6203
Finanzierungs-Informationen
Open-Access-Publikationskosten wurden durch die Deutsche Forschungsgemeinschaft und die Universität Bielefeld gefördert.
Page URI
https://pub.uni-bielefeld.de/record/2939901

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Scholz S, Greiner W. An exclusive human milk diet for very low birth weight newborns—A cost-effectiveness and EVPI study for Germany. PLOS ONE. 2019;14(12): e0226496.
Scholz, S., & Greiner, W. (2019). An exclusive human milk diet for very low birth weight newborns—A cost-effectiveness and EVPI study for Germany. PLOS ONE, 14(12), e0226496. doi:10.1371/journal.pone.0226496
Scholz, S., and Greiner, W. (2019). An exclusive human milk diet for very low birth weight newborns—A cost-effectiveness and EVPI study for Germany. PLOS ONE 14:e0226496.
Scholz, S., & Greiner, W., 2019. An exclusive human milk diet for very low birth weight newborns—A cost-effectiveness and EVPI study for Germany. PLOS ONE, 14(12): e0226496.
S. Scholz and W. Greiner, “An exclusive human milk diet for very low birth weight newborns—A cost-effectiveness and EVPI study for Germany”, PLOS ONE, vol. 14, 2019, : e0226496.
Scholz, S., Greiner, W.: An exclusive human milk diet for very low birth weight newborns—A cost-effectiveness and EVPI study for Germany. PLOS ONE. 14, : e0226496 (2019).
Scholz, Stefan, and Greiner, Wolfgang. “An exclusive human milk diet for very low birth weight newborns—A cost-effectiveness and EVPI study for Germany”. PLOS ONE 14.12 (2019): e0226496.
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2020-01-13T09:37:09Z
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