Objectives: To perform economic evaluation of donor breast milk (DBM) (using clinical breast pump) or artificial formula (AF) for premature infants in the neonatal intensive care unit (NICU) for Russian healthcare setting. Methods: We calculated the cost of providing 100 ml of DBM using clinical breast pump and 100 ml of AF for premature infants in the NICU. The total cost of providing DBM was measured as: the breast pump cost, the individual pumping set cost and staff costs. The cost of providing AF was calculated using the mean cost per 100 ml for powdered AF and staff costs. We also calculated the cost per averted case of necrotizing enterocolitis (NE) for premature infant when breastfeeding instead of the AF is used. The cost of the averted NE was obtained using the difference in cost of feeding during the period, required for NE development and number of patients "needed to treat" (NNT) to prevent 1 NE case derived from the clinical trials. Besides we calculated the DBM cost when breast milk fortifier (BMF) is added for low-weight infants. Results: The costs per 100 ml of AF and DBM were similar (0,67 EUR and 0,77 EUR respectively). The cost per averted case of NE was 344,5 EUR within 35 days that is less than NE treatment. The difference in costs (in favor of AF) amounted to 2,87 EUR per 100 ml with the use of BMF. Conclusions: The cost of DBM is comparable to the cost of AF, with a significant DBM clinical benefit. The costs per averted NE within 35 days shows that DBM is acceptable from the position of Russian health care system. When calculating the costs of DBM with the use of BMF, DBM costs exceed those for AF for more than 5 times.
Gerasimova, K., & Avxentyeva, M. (2015). The Cost Of Nutrition Alternatives For Premature Infants In The Neonatal Intensive Care Unit In Russia. Value in Health, 18(7), A351. https://doi.org/10.1016/j.jval.2015.09.643