Lebensqualität, Therapiebeanspruchung und Kosten von Frühgeborenen mit einem Geburtsgewicht &amp;lt;1250g im Vergleich zu Termingeborenen – Eine Untersuchung im Erwachsenenalter

Baumgardt, Melanie; Bucher, HU; Td, Szucs; Fauchère, JC

doi:10.1055/s-0030-1261379

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“…Taking newborns with a birth weight of 750-999g as an example, the immediate inpatient care in neonatal intensive care units or regular care units including no significant operating procedure has a mean cost of €72,702 in Germany and increases to €121,594 for a birth weight below 600g [22]. The long-term effects were found to be €120.60 per patient per year for direct health care costs [23]. Reducing the complication rates associated with a very low birth weight birth may also lead to a reduction in the expenditure for neonatal and long-term care of these infants.…”

Section: Introductionmentioning

confidence: 99%

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

Scholz

Greiner

2019

PLoS ONE

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ObjectivesHuman 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.MethodsA 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.ResultsIn 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.ConclusionAdopting EHMD as the standard approach to nutrition is a cost-effective intervention for very low birth weight newborns in Germany.

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Section: Introductionmentioning

confidence: 99%