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Cited by 64Clinical Nutrition and GastroenterologyNutrition and Health in AgingHealth Systems, Economic Evaluations, Quality of Life

The Cost-Effectiveness of Oral Nutrition Supplementation for Malnourished Older Hospital Patients

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Zhong, Yue, Cohen, Joshua T., Goates, Scott, Luo, Menghua, Nelson, Jeffrey, Neumann, Peter J.·2017·Applied Health Economics and Health Policy
DOI 10.1007/s40258-016-0269-7PMC PMC5253145
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Abstract

Background Malnutrition, which is associated with increased medical complications in older hospitalized patients, can be attenuated by providing nutritional supplements. Objective This study evaluates the cost effectiveness of a specialized oral nutritional supplement (ONS) in malnourished older hospitalized patients. Methods We conducted an economic evaluation alongside a multicenter, randomized, controlled clinical trial (NOURISH Study). The target population was malnourished older hospitalized patients in the USA. We used 90-day (base case) and lifetime (sensitivity analysis) time horizons. The study compared a nutrient-dense ONS, containing high protein and β-hydroxy-β-methylbutyrate to placebo. Outcomes included health-care costs, measured as the product of resource use and per unit cost; quality-adjusted life-years (QALYs) (90-day time horizon); life-years (LYs) saved (lifetime time horizon); and the incremental cost-effectiveness ratio (ICER). All costs were inflated to 2015 US dollars. Results In the base-case analysis, 90-day treatment group costs averaged US$22,506 per person, compared to US$22,133 for the control group. Treatment group patients gained 0.011 more QALYs than control group subjects, reflecting the treatment group's significantly greater probability of survival through 90 days' follow-up, as reported by the clinical trial. Hence, the 90-day follow-up period ICER was US$33,818/QALY. Assuming a lifetime time horizon, estimated treatment group life expectancy exceeded control group life expectancy by 0.71 years. Hence, the lifetime ICER was US$524/LY. The follow-up period for the trial was relatively short. Some of the patients were lost to follow-up, thus reducing collection of health-care utilization data during the clinical trial. Conclusion Our findings suggest that the investigative ONS cost-effectively extends the lives of malnourished hospitalized patients.

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  • According to an economic evaluation of the NOURISH study by Zhong et al., provision of high protein bHMB ONS had an incremental cost-effectiveness ratio of 524 $/life years, concluding that this intervention was cost effective and positive in terms of survival for the patients.

    “According to this analysis the provision of high protein bHMB ONS had an incremental cost-effectiveness ratio (ICER) of 524 $/life years, concluding that this intervention was cost effective and positive in terms of survival for the patients [49] (Level of Evidence 1þþ).”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [49]

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Cited by

Sorted by citations

  • ESPEN guideline on nutritional support for polymorbid medical inpatients

    Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works

    “According to this analysis the provision of high protein b HMB ONS had an incremental cost-effectiveness ratio (ICER) of 524 $/life years, concluding that this intervention was cost effective and positive in terms of survival for the patients [49] (Level of Evidence 1 þþ ).”

Authors
Zhong, Y., Cohen, J. T., Goates, S., Luo, M., Nelson, J., & Neumann, P. J.
Affiliations
  • Tufts Medical Center (US)
  • Abbott Nutrition (United States) (US)
Corresponding author
Zhong, Yue
ORCID
Venue
Applied Health Economics and Health Policy
Publisher
Springer Science and Business Media LLC
Published
2016-08-04
Volume
15
Issue
1
Pages
75-83
ISSN
  • 1175-5652 (ISSN-L)
  • 1179-1896
DOI
10.1007/s40258-016-0269-7
PMC
PMC5253145
OpenAlex
W2477764198
Cited by
64
References
4
Citations by year
2026: 7 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 6 · 2021: 6 · 2020: 7 · 2019: 6 · 2018: 10 · 2017: 3 · 2016: 2
FWCI
7.33
Type
journal article
Language
en
Open access
Licence
Locations
  • Applied Health Economics and Health Policy (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
Abbott Nutrition
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
oral nutritional supplementation, malnutrition, hospitalized older adults, cost-effectiveness, beta-hydroxy-beta-methylbutyrate, quality-adjusted life years, life-years saved, health care costs
MeSH terms
Aged, Cost-Benefit Analysis, Hospitalization, Humans, Health Care Costs, Hospital Costs, Quality-Adjusted Life Years, Malnutrition, Nutrition Therapy

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