Cost-Effectiveness of a Specialized Oral Nutritional Supplementation for Malnourished Older Adult Patients in Spain
Open accessAbstract
Malnutrition has been related to prolonged hospital stays, and to increases in readmission and mortality rates. In the NOURISH (Nutrition effect On Unplanned Readmissions and Survival in Hospitalized patients) study, administering a high protein oral nutritional supplement (ONS) containing beta-hydroxy-beta-methylbutyrate (HP-HMB) to hospitalised older adult patients led to a significant improvement in survival compared with a placebo treatment. The aim of this study was to determine whether HP-HMB would be cost-effective in Spain. We performed a cost-effectiveness analysis from the perspective of the Spanish National Health System using time horizons of 90 days, 180 days, 1 year, 2 years, 5 years and lifetime. The difference in cost between patients treated with HP-HMB and placebo was €332.75. With the 90 days time horizon, the difference in life years gained (LYG) between both groups was 0.0096, resulting in an incremental cost-effectiveness ratio (ICER) of €34,700.62/LYG. With time horizons of 180 days, 1 year, 2 years, 5 years and lifetime, the respective ICERs were €13,711.68, €3377.96, €2253.32, €1127.34 and €563.84/LYG. This analysis suggests that administering HP-HMB to older adult patients admitted to Spanish hospitals during hospitalisation and after discharge could be a cost-effective intervention that would improve survival with a reduced marginal cost.
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According to an analysis by Ballesteros-Pomar et al. from the perspective of the Spanish National Health System in patients included in the NOURISH study, the intervention proved to be cost effective, improved survival and marginally reduced cost of treatment.
“According to their analysis the intervention proved to be cost effective, improved survival and marginally reduced cost of treatment [50] (Level of evidence 1þ).”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [50]
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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 their analysis the intervention proved to be cost effective, improved survival and marginally reduced cost of treatment [50] (Level of evidence 1 þ ).”
Self-citation
- Authors
- Ballesteros-Pomar, M., Martínez Llinàs, D., Goates, S., Sanz Barriuso, R., & Sanz-Paris, A.
- Affiliations
- Complejo Asistencial Universitario de León (ES)
- Oblikue Consulting, Carrer del Comte d’Urgell 240 2ºD, 08036 Barcelona, Spain
- Abbott Nutrition (United States) (US)
- Scientific Affairs & Training, Abbott Nutrition International, Abbott Laboratories, S.A., Avenida de Burgos 91, 28050 Madrid, Spain
- Servicio de Endocrinología y Nutrición, Hospital Universitario Miguel Servet, Paseo Isabel la Católica 1–3, 50009 Zaragoza, Spain
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2018-02-22
- Volume
- 10
- Issue
- 2
- Pages
- 246
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC5852822
- OpenAlex
- W2790086291
- Cited by
- 30
- References
- 5
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 1
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Zaguan (University of Zaragoza Repository) (submittedVersion, cc-by)
- Funders
- Abbott Laboratories Ltd
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- cost-effectiveness, oral nutritional supplementation, beta-hydroxy-beta-methylbutyrate, malnutrition, older adults, hospitalized patients, survival, unplanned hospital readmission, life-years gained, Spanish National Health System
- MeSH terms
- Administration, Oral, Age Factors, Aged, Cost-Benefit Analysis, Dietary Proteins, Enteral Nutrition, Female, Hospitalization, Humans, Male, Nutritional Status, Spain, Time Factors, Valerates, Geriatric Assessment, Treatment Outcome, Cost Savings, Hospital Costs, Models, Economic, Malnutrition
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