A comparison of tertiary level NICU costs for infants born <1250 g supplemented with human versus bovine milk-based fortifiers

Telford Yeung; Asaph Rolnitsky; Nicole Bando; Susan Trang; Andy Geer; Alex Kiss; Deborah L O'Connor; Sharon Unger

doi:10.1038/s41372-023-01677-6

A comparison of tertiary level NICU costs for infants born <1250 g supplemented with human versus bovine milk-based fortifiers

J Perinatol. 2023 Sep;43(9):1113-1118. doi: 10.1038/s41372-023-01677-6. Epub 2023 Apr 21.

Authors

Telford Yeung^{1

2}, Asaph Rolnitsky^{3

4}, Nicole Bando⁵, Susan Trang⁶, Andy Geer⁷, Alex Kiss^{8

9}, Deborah L O'Connor^{1

5

6}, Sharon Unger^{10

11

12}

Affiliations

¹ Department of Pediatrics, Sinai Health, Toronto, ON, Canada.
² Section of Neonatology, Windsor Regional Hospital, Windsor, ON, Canada.
³ Neonatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
⁴ Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
⁵ Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada.
⁶ Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.
⁷ System Funding and Analytics, Sinai Health, Toronto, ON, Canada.
⁸ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
⁹ Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
¹⁰ Department of Pediatrics, Sinai Health, Toronto, ON, Canada. Sharon.unger@sinaihealth.ca.
¹¹ Department of Pediatrics, University of Toronto, Toronto, ON, Canada. Sharon.unger@sinaihealth.ca.
¹² Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada. Sharon.unger@sinaihealth.ca.

PMID: 37085523
DOI: 10.1038/s41372-023-01677-6

Abstract

Background: Human milk-based fortifiers (HMBF) are more costly than bovine milk-based fortifiers (BMBF); but, the efficacy of human or bovine fortification for infants born <1250 g has yet to be fully elucidated. Our objective was to determine the effect of fortifier source on tertiary neonatal costs.

Methods: Costs associated with tertiary neonatal care, including direct and indirect hospital expenditures, feed-related costs and physician billing were analysed retrospectively for participants of OptiMoM (NCT02137473), a blinded RCT comparing fortifier type for babies born <1250 g. A generalized linear model of cost according to fortifier type was created.

Results: Mean [95% confidence interval] daily costs per patient, adjusted for birth gestation and weight, was significantly greater in the human than the BMBF group ($3,452 [$3,186 - $3,740] Canadian dollars (CAD) versus $2,451 [$2,257 - $2,662] CAD) respectively, p < 0.0001).

Conclusion: HMBF usage entails additional costs on NICU stay that should be considered with implementation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Canada
Food, Fortified
Humans
Infant, Newborn
Infant, Premature*
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Milk, Human*
Randomized Controlled Trials as Topic
Retrospective Studies

Grants and funding

FDN 143233/CIHR/Canada