Treatment Options for Cow’s Milk Protein Allergy: A Modeling Analysis
Received 12 December 2019
Accepted for publication 18 March 2020
Published 17 June 2020 Volume 2020:12 Pages 307—315
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Professor Dean Smith
Mehmet Berktas,1 Feza Kirbiyik,2 Elif Aribal,2 Anil Aksit,2 Derya Ufuk Altintas3
1Blue Idea Consulting, London, UK; 2Nutricia Advanced Medical Nutrition, Istanbul, Turkey; 3Cukurova University Medical School, Allergy and Immunology Department, Adana, Turkey
Correspondence: Mehmet Berktas
Blue Idea Consulting, 42 Trafalgar House, London W5 2TJ, UK
Tel +44 7833 067120
Purpose: Cow’s milk protein allergy (CMPA) is one of the most common food allergies in early childhood. We aimed to evaluate clinical and economic outcomes of the amino-acid formula (AAF) and extensively hydrolyzed formula (eHF) based treatment of CMPA by using data available from Turkey and otherwise from literature.
Materials and Methods: A theoretical model was developed to evaluate AAF and eHF for CMPA treatment in terms of the number of children tolerating formula or experiencing an allergic reaction or withdrawing formula due to taste or other palatability features and CMPA related direct medical costs from the payer perspective.
Results: We estimated that 13,000 children are diagnosed with CMPA in 1 year in Turkey. For the children receiving AAF, it is estimated that 83.7% tolerate AAF until the 24th month, and the total cost for the children tolerating AAF is estimated at 20.6 million€. The average cost per child tolerating AAF until the 24th month is estimated at 1895€. On the other hand, 48.7% are estimated to tolerate eHF until the 24th month, and the total cost for the children tolerating eHF is estimated at 12.3 million€ and the average cost per child tolerating eHF until the 24th month is estimated at 1940€.
Conclusion: The analysis revealed that the management of CMPA is associated with the economic burden on the healthcare system in Turkey. Treatment of CMPA with AAF seems to provide better clinical outcomes (high tolerability and less withdrawal due to taste or an allergic reaction) and to be an option with economic benefits when Turkey-specific conditions are considered.
Keywords: amino-acid formula, extensively hydrolyzed formula, pharmacoeconomic modeling, cow’s milk protein allergy
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