Cost-effectiveness of a 3-month intervention with oral nutritional supplements in disease-related malnutrition: a randomised controlled pilot study
Open accessAbstract
Background/objectives Nutritional intervention with oral nutritional supplements (ONS) has been shown to increase quality of life in malnourished patients. We investigated whether post-hospital supplementation with ONS is cost-effective according to international benchmarks in malnourished patients. Subjects/methods In total, 114 malnourished patients (50.6±16.1 years, 57 female) with benign gastrointestinal disease were included and randomised to receive either ONS for 3 months and dietary counselling at discharge (intervention, n=60) or only dietary counselling at discharge (control group, n=54). Nutritional status was assessed with Subjective Global Assessment. Intervention patients documented daily intake of ONS; quality of life was assessed with Short-Form (SF)-36 Health Survey and SF-36 values were transformed into health-status utilities. Quality-adjusted life years (QALYs) were calculated by adopting the area under the curve method. We used two different pricing scenarios for ONS (minimum price: [euro]2.30 and maximum: [euro]2.93/tetrapack). The incremental cost-effectiveness ratio (ICER) of supplementation with ONS was calculated for both price scenarios. All analyses were corrected for age and gender. Results Intervention patients consumed 2.4±0.8 ONS per day. Intervention and control patients did not differ in their health status utilities at baseline (0.594±0.017 vs 0.619±0.018), but after 3 months, the health status utilities were significantly higher in intervention patients than in control patients (0.731±0.015 vs 0.671±0.016, P=0.028). Intervention was associated with significantly higher costs (ICER: [euro]9497 and [euro]12,099/additional QALY, respectively) but deemed cost-effective according to international thresholds (< [euro]50,000/QALY). Conclusions A 3-month intervention with ONS increases quality of life in malnourished patients. This treatment appears to be cost-effective according to international benchmarks.
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In younger malnourished patients (50.6±16.1 years) with benign gastrointestinal or liver disease who received ONS during hospital stay and for three months post discharge, QoL assessed by SF-36 was significantly improved in IG compared to CG (mean improvement at three months 0.128, 95% CI 0.095 to 0.161 in IG vs 0.067, 95% CI 0.031 to 0.103 in CG).
“In younger malnourished patients (50.6 ± 16.1 years) with benign gastrointestinal or liver disease who received ONS during their hospital stay and for three months post discharge, QoL assessed by the 36-Item Short Form Health Survey questionnaire was significantly improved in the IG patients (n ¼ 60) compared to the CG patients (n ¼ 54) (mean improvement at three months was 0.128, 95% CI 0.095 to”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [123]
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- Authors
- Norman, K., Pirlich, M., Smoliner, C., Kilbert, A., Schulzke, J. D., Ockenga, J., Lochs, H., & Reinhold, T.
- Affiliations
- Stiftung Charité (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Klinikum Bremen-Mitte (DE)
- Corresponding author
- Norman, K
- Venue
- European Journal of Clinical Nutrition
- Published
- 2011-03-16
- Volume
- 65
- Issue
- 6
- Pages
- 735-742
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W2159869190
- Cited by
- 75
- References
- 32
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 5 · 2019: 6 · 2018: 5 · 2017: 4 · 2016: 2 · 2015: 8 · 2014: 9 · 2013: 6 · 2012: 4
- FWCI
- 5.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Trinity's Access to Research Output (TARA) (Trinity College Dublin) (submittedVersion)
- 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 supplements, disease-related malnutrition, cost-effectiveness, benign gastrointestinal disease, quality of life, quality-adjusted life years, nutrition counseling, incremental cost-effectiveness ratio
- MeSH terms
- Adult, Energy Intake, Cost-Benefit Analysis, Dietary Proteins, Female, Gastrointestinal Diseases, Health Status, Humans, Male, Middle Aged, Pilot Projects, Quality of Life, Treatment Outcome, Quality-Adjusted Life Years, Area Under Curve, Dietary Supplements, Malnutrition, Nutrition Therapy
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