Author(s)
Miqdady M1, Tzivinikos C2, Siddiqui A2, Al Mutairy S3, Al-Ahmedi N4, Alsawi N5, Eldegeir M6, Goronfolah L7, Negm Y2, Krishnamoorthy B8, Elghoudi A9, Al Hameli H10, Cremonesini D9, AlAtawi K11, Al Enezy M12, Hussein A13, Thomas E13, Al Damerdash Z13, Raxworthy M14, Abdelmawla A15, El Ojeil R16
1Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates, 2Galila Hospital, Dubai, United Arab Emirates, 3King Faisal Specialized Hospital, Riyadh, Saudi Arabia, 4Maternity and Children Hospital, Madinah, Saudi Arabia, 5Soliman Alhabeeb Hospital, Riyadh, Saudi Arabia, 6National Guard Hospital, Riyadh, Saudi Arabia, 7National Guard Hospital, Jeddah, Saudi Arabia, 8MEDICLINIC CITY HOSPITAL, Dubai, United Arab Emirates, 9Al Ain Hospital, Al Ain, United Arab Emirates, 10Cleveland Clinic, Abu Dhabi, United Arab Emirates, 11Dubai health authority, Dubai, United Arab Emirates, 12Sabah Hospital Dar al shefa, Kuwait, Kuwait, 13Amiri Hospital, Kuwait, Kuwait, 14Nutricia Specialized Nutrition, Dubai, United Arab Emirates, 15Nutricia Specialized Nutrition, United Arab Emirates, 16IQVIA, Keserwan, JL, Lebanon
OBJECTIVES: Cow’s milk protein allergy (CMPA) is the most common food allergy in infants, affecting ~5% of infants globally. Appropriate substitution for cow milk products is imperative in the critical growing period for infants and to avoid malnutrition and/or nutrient deficiencies. Almost 100% of infants with CMPA will respond to an amino acid formula (AAF), this may allow to use AAF as a therapeutic trail with high negative predictive value. The lack of response to an AAF formula excludes CMPA in clinical practice. The objectives were to estimate the budget impact (BI) of early introduction of AAF (Neocate®) on healthcare payers’ budget in Gulf Co-operation Council (GCC) countries for CMPA management. METHODS: BI estimation was conducted for three GCC countries: Kingdom of Saudi Arabia (KSA), Kuwait and United Arab Emirates (UAE) in children <24 months suspected with CMPA. A global decision tree model was adapted to compare the estimated costs in current practice where AAF is used as first-line therapeutic trial of suspected CMPA versus current practice of testing, medications, and referral or using alternative formulae. Model inputs included population data, total costs associated with drug acquisition and disease management. RESULTS: The proposed early introduction of AAF (Neocate®) in the management of CMPA exhibited considerable cost savings; 10% (SAR 15,102,542) in KSA, 10% (KWD 306,565) in Kuwait, 17% (AED 1,842,018) in UAE government sector, and 13% (AED 4,232,932) in UAE private sector. The cost impact was driven primarily by minimal use of soy formula in both KSA (58%; SAR 4,204,540), reduced medication cost in Kuwait (37%; KWD 5,630) and decreased examination cost in UAE-government sector (58%; AED 351,919) and private sector (50%; AED 1,508,918). CONCLUSIONS: The early introduction of AAF (Neocate®) in children <24 months suspected with CMPA will be cost-saving from a healthcare payer’s perspective of GCC countries for the management of CMPA.
