Budget Impact of Early Introduction of Amino Acid Formula in Managing Infants with Cow Milk Protein Allergy: Arabian Gulf Countries’ Experience

Abstract

Mohamad Miqdady,1,2 Saif AlMutaeri,3 Najwa Alsawi,4 Loie Goronfolah,5 Christos Tzivinikos,6 Hamad Al Hameli,7 David Cremonesini,8 Mohammed Al-Enezi,9 Ahmad Hussain,10 Zainab Al Damerdash,11 Mohammed Al-Biltagi12,13 1American Board of Pediatrics Gastroenterology, Hepatology & Nutrition, Chief Pediatric Gastroenterologist, Hepatology & Nutrition Division, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; 2College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates; 3King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia; 4Sulaiman Al Habib Private Sector Hospital, Riyadh, Kingdom of Saudi Arabia; 5National Guard Jeddah Government Hospital, Jeddah, Kingdom of Saudi Arabia; 6Al Jalila Children’s Specialty Hospital, Dubai, United Arab Emirates; 7Cleveland Clinic, Abu Dhabi, United Arab Emirates; 8Al Ain Hospital, Al Ain, Abu Dhabi, United Arab Emirates; 9Dar Al-Shefa Hospital, Hawally, Kuwait; 10Amiri Hospital/Salam Hospital, Kuwait City, Kuwait; 11Amiri Hospital, Kuwait City, Kuwait; 12Faculty of Medicine, Tanta University, Tanta, Egypt; 13King Abdullah Medical City, Arabian Gulf University, Dr. Sulaiman Al Habib Medical Group, Manama, Kingdom of BahrainCorrespondence: Mohammed Al-Biltagi, Faculty of Medicine, Tanta University, Tanta, Egypt, Tel [phone], Email [email protected]: This study estimates the budgetary impact of the introduction of amino-acid formula (AAF) as first-line management in the elimination diet of infants with suspected cow milk protein allergy (CMPA) in the Kingdom of Saudi Arabia (KSA), Kuwait, and the United Arab Emirates (UAE) from a health-care payer’s perspective.Methods: A global decision tree model was adapted to compare estimated costs in current practice (extensively hydrolyzed formula [eHF] or soy formula [SF] with the proposed approach of early introduction of AAF as first-line treatment of CMPA in non-breast-fed infants). Model inputs were derived from explorative literature reviews and medical experts’ opinions. All costs were reported in local currency, ie, Saudi Riyal (SAR) for KSA, Kuwaiti Dinar (KWD) for Kuwait, and United Arab Emirates Dirham (AED) for the UAE.Results: Cost savings with the early introduction of AAF were 10% (SAR 15102542) in KSA, 10% (KWD 306565) in Kuwait, 17% (AED 1842018) in the UAE government sector and 13% (AED 4232932) in the UAE private sector. The highest cost reduction was observed in the cost of soy formula (SF), with a 58% reduction both in KSA (SAR 4204540) and UAE public sector (AED 110331). A significant cost reduction in medication costs in Kuwait (37%; KWD 5630) and medical examination costs in the UAE private sector (50%; AED 1508918) was observed.Conclusion: Results indicated that the introduction of AAF as the first line in the management of CMPA is a cost-saving strategy for the Gulf Cooperation Council (GCC) countries—KSA, Kuwait, and UAE— from a health-care payer’s perspective.Keywords: cow’s milk protein allergy, amino acid formula, infants, Kingdom of Saudi Arabia, Kuwait, United Arab Emirates, Arabian Gulf

Keywords

• objective: this study estimates the budgetary impact of the introduction of amino-acid formula (aaf) as first-line management in the elimination diet of infants with suspected cow milk protein allergy (cmpa) in the kingdom of saudi arabia (ksa)
• kuwait
• and the united arab emirates (uae) from a healthcare payer’s perspective. methods: a global decision tree model was adapted to compare estimated costs in current practice (extensively hydrolyzed formula [ehf] or soy formula [sf] with the proposed approach of early introduction of aaf as first-line treatment of cmpa in non-breast-fed infants. model inputs were derived from explorative literature reviews and medical experts’ opinions. all costs were reported in local currency
• i.e.
• saudi riyal (sar) for ksa
• kuwaiti dinar (kwd) for kuwait
• and united arab emirates dirham (aed) for the uae. results: cost savings with the early introduction of aaf were 10% (sar 15
• 102
• 542) in ksa
• 10% (kwd 306
• 565) in kuwait
• 17% (aed 1
• 842
• 018) in the uae government sector and 13% (aed 4
• 232
• 932) in the uae private sector. the highest cost reduction was observed in the cost of soy formula (sf)
• with a 58% reduction both in ksa (sar 4
• 204
• 540) and uae public sector (aed 110
• 331). a significant cost reduction in medication costs in kuwait (37%
• kwd 5
• 630) and medical examination costs in the uae private sector (50%
• aed 1
• 508
• 918) was observed. conclusion: results indicated that the introduction of aaf as the first line in the management of cmpa is a cost-saving strategy for the gulf cooperation council (gcc) countries—ksa
• kuwait
• and uae— from a healthcare payer’s perspective.