Dear Lactnet Friends:

J Med Econ. <http://www.ncbi.nlm.nih.gov/pubmed/20469979> 2010;13(2):273-83.
Budget impact of managing cow milk allergy in the Netherlands.
Sladkevicius E<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sladkevicius%20E%22%5BAuthor%5D>
, Guest JF<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Guest%20JF%22%5BAuthor%5D>
.
 Source

Catalyst Health Economics Consultants, Northwood, Middlesex, UK.
Abstract OBJECTIVE:

To assess the resource implications and budget impact of managing cow milk
allergy (CMA) in the Netherlands from the perspective of the healthcare
insurers.
METHODS:

A model was constructed depicting the management of CMA in the Netherlands
using information obtained from interviews with youth healthcare doctors (n
= 14), general practitioners (n = 6) and paediatricians (n = 11) with
relevant clinical experience of managing CMA. The model was used to estimate
the expected level of healthcare resource use and corresponding cost (at
2007/08 prices) attributable to managing 4,382 new CMA sufferers.
RESULTS:

The expected cost of healthcare resource use attributable to managing 4,382
new CMA sufferers up to 1 year of age following initial consultation with a
community-based physician at a mean 3 months of age was estimated to be
€11.28 (95% CI: €7.82; €14.33) million. Clinical nutrition preparations
emerged as the primary cost driver accounting for 91% of the total cost and
clinician visits collectively accounted for a further 5%. The time taken for
CMA sufferers to be put on an appropriate diet and achieve symptom
resolution was estimated to be 30 (95% CI: 27; 32) days. Sensitivity
analysis showed that the costs would increase by approximately 16% if all
new CMA sufferers were to undergo a double-blind placebo-controlled cow milk
challenge in a hospital setting, as is currently being proposed. It is not
clear how this proposal would affect time to symptom resolution since this
would depend on the efficiency of hospitals being able to deal with the
increased workload.
LIMITATIONS:

The intolerance rates were derived from a 1-year follow-up study among 1,000
infants with CMA in the UK, healthcare resource use was not collected
prospectively and the study period was censured at 1 year of age and does
not consider the impact of CMA in subsequent years. However, most children
outgrow this form of allergy during their second year.
CONCLUSION:

Within the model's limitations, CMA imposes a substantial burden on the
Dutch healthcare system. Moreover, initiating a double-blind
placebo-controlled cow milk challenge for all CMA sufferers will potentially
increase clinicians' workload and use of limited resources within paediatric
hospital departments in the Netherlands.

warmly,

Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC
craniosacral therapy practitioner
www.breastfeedingalwaysbest.com

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome