Prolacta budget impact analysis

  • Research type

    Research Study

  • Full title

    Budget impact analysis of an exclusive human milk diet for very preterm babies in England

  • IRAS ID

    283102

  • Contact name

    Christopher James Sampson

  • Contact email

    csampson@ohe.org

  • Sponsor organisation

    Office of Health Economics

  • Duration of Study in the UK

    0 years, 6 months, 0 days

  • Research summary

    Babies born before 30 weeks’ gestation are at increased risk of major clinical complications including necrotising enterocolitis (NEC), sepsis, and mortality. Clinical management of preterm babies is further complicated by their nutritional requirements, which is greater than that of full-term babies. In some cases, a mother’s own milk is not sufficient – in volume or nutritional content – to meet preterm babies’ needs. Consequently, both preterm formulas and milk fortifiers are used to feed preterm infants.

    In England, routinely used fortifiers and formulas are derived from cows’ milk. However, the use of bovine milk in preterm infants has been shown to be associated with adverse health outcomes. Studies have found that an exclusive human milk diet (EHMD) – based on a mother’s own milk alongside fortifiers and formulas manufactured from donor human milk – is associated with reduced risk of NEC, sepsis, neurodevelopmental problems, and lung disease.

    The aim of this study is to estimate the budget impact of introducing an EHMD for very premature babies in England, from the perspective of the National Health Service (NHS), compared with current practice. Resource use will be estimated for a cohort of babies born before 30 weeks’ gestation in 2019.

    No new data will be collected specifically for the purpose of this study. We will analyse data that are collected as part of the National Neonatal Research Database (NNRD), supplemented with information from published studies.

    An EHMD is likely to be associated with higher upfront costs for the provision of nutrition. However, the major cost of neonatal care in England is attributable to time spent in a hospital neonatal unit. If an EHMD reduces the time spent in high-dependency care, there is potential for it to be cost-saving overall, and thereby reduce the overall costs for the NHS.

  • REC name

    London - Bloomsbury Research Ethics Committee

  • REC reference

    20/PR/0759

  • Date of REC Opinion

    8 Jan 2021

  • REC opinion

    Favourable Opinion