126 Is Prevention of Atopic Dermatitis with Hydrolysate Formulas Cost Effective? An Application of Results of the Gini-Study to the German Situation

Abstract

Background and aims: Atopic eczema generates a high economic burden, eg. 1.2-3.5 billion € per annum in Germany. The GINI trial, a prospective, randomized, double-blind intervention study in Germany that recruited a cohort of 2,252 infants with parental and/or sibling-related heredity for atopy between 1995 and 1998 showed that children fed with certain hydrolysate formulas at least the first four months of life have a reduction of the relative risk for atopic dermatitis by 26-45% compared to a cow's milk formula. The objective of this study was to assess the cost-effectiveness of feeding hydrolysate formulas in the prevention of atopic eczema. Methods: Cost-effectiveness was assessed with a decision tree model programmed with the software TreeAge. Children were followed over a 6 year period. Costs and effects were analyzed using the perspective of the German statutory health insurance (SHI) and a societal perspective. Results: In the base case scenario both the partial whey hydrolysate and the extensively hydrolysed casein formula-feeding are cost-effective in preventing infantile atopic eczema from a societal perspective. In the sixth year both formulas generated cost-savings. From the SHI perspective, the extensively hydrolysed casein formula was cost-effective and the partial whey hydrolysate cost-saving after six years. The third formula, an extensively hydrolysed whey formula, was dominated in both analyses. Conclusion: Our results show that for the prevention of atopic eczema two formulas can be cost-effective or even cost-saving depending on the scenario. Economic studies indicate that atopic dermatitis generates a high economic burden.