Presentation (CTI)

OBJECTIVES: Very low birth weight (VLBW) infants incur the highest rate of neonatal intensive care unit (NICU) admissions. This elevated admission rate is driven by severe prematurity-associated morbidities and prolonged hospitalization. The nutritional practice for VLBW infants often relies on a bovine (BOV)-based diet, which has been associated with adverse outcomes including mortality, late onset sepsis (LOS), necrotizing enterocolitis (NEC), and other comorbidities compared to infants fed on 100% human milk-based products. This study aimed to evaluate the budget impact of implementing exclusive human milk diet (EHMD) compared to BOV-based diet for VLBW infants, from the perspective of Sheikh Shakhbout Medical City (SSMC), a major tertiary hospital in the United Arab Emirates (UAE).
METHODS: The analysis was conducted over a five-year horizon using a decision tree model. Patients entered the model through one of two arms and transitioned to one of the following mutually exclusive health states: NEC, LOS, both NEC and LOS, or neither. The model incorporated direct medical costs related to diets, health states management, complication treatment, and follow-up care. Clinical parameters were retrieved from published literature and expert consensus. Deterministic one-way sensitivity analyses were conducted to evaluate the robustness of model outcomes.
RESULTS: The integration of EHMD demonstrated a total cost of AED 171.22 million over a five-year time horizon, compared to AED 207.92 million for the standard of care preterm formula. The savings stratified by birth weight ranged from AED 1.96 million for infants weighing 1250-1499 g to AED 18.30 million for those weighing 500-749 g. This generated a total budget savings of AED 36.70 million over the study period.
CONCLUSIONS: The adoption of EHMD yielded notable budget savings from SSMC’s perspective. These savings were primarily driven by EHMD's clinical benefit, including fewer prematurity-associated comorbidities and reduced hospital stay.