High-risk infants fed with standard cow’s milk formula as a supplement or replacement of breast milk may be exposed to a higher likelihood of developing atopic dermatitis

Background: Atopic dermatitis (AD) is one of the most common skin conditions among infants. Proteins found in cow’s milk formula (CMF) have been found to be attributable to heightened AD risk, particularly in infants with familial AD heredity. Previous studies have suggested that intervention with partially hydrolyzed formula in nonexclusively breastfed infants can have a protective effect against AD development. Objective: The aim of the present study was to compare the estimates of the economic impact of reducing the AD incidence by feeding a partially hydrolyzed whey-based formula (PHF-W) instead of a standard CMF to high-risk nonexclusively breastfed urban infants for the first 17 weeks of life in the Philippines, Malaysia, and Singapore. Methods: In each country, a mathematical model simulated AD incidence and burden from birth to 6 years of age of using PHFW versus CMF in the target population using data from the German Infant Nutritional Intervention study. The models integrated literature, current cost and market data, and expert clinician opinion. Modeled outcomes included AD risk reduction, time spent after AD diagnosis, AD symptom-free Published online: April 24, 2015 Marc Botteman Pharmerit International 4350 East West Highway, Suite 430 Bethesda, MD 20814 (USA) E-Mail mbotteman @ pharmerit.com © 2015 S. Karger AG, Basel 0250–6807/15/0665–0026$39.50/0 www.karger.com/anm Key Messages • The objective of the present study was to compare the estimates of the economic impact of reducing the incidence of atopic dermatitis (AD) by feeding a partially hydrolyzed whey-based formula instead of a standard cow’s milk formula to high-risk nonexclusively breastfed urban infants for the first 17 weeks of life in the Philippines, Malaysia, and Singapore. • Mathematical models integrating literature, current costs, and expert clinician opinion were used. Modeled outcomes included AD risk reduction, time spent after AD diagnosis, AD symptom-free days, quality-adjusted life years, and costs (direct and indirect). • Feeding high-risk urban infants partially hydrolyzed formulas instead of standard infant formula resulted in an estimated significant risk reduction of developing AD, a 0.69-year reduction in the time spent after AD diagnosis, and 16to 38-day reductions of flares, depending on the country. • The per-child AD-related 6-year cost-saving estimates when feeding high-risk infants with partially hydrolyzed whey-based formula versus cow’s milk formula were USD 739 in Singapore, USD 372 in Malaysia, and USD 237 in the Philippines. D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /2 5/ 20 17 9 :0 8: 43 P M