Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing. Issue 1 (February 2017)

• Record Type: Journal Article
• Authors: Cereda, Emanuele; Klersy, Catherine; Andreola, Manuela; Pisati, Roberto; Schols, Jos M.G.A.; Caccialanza, Riccardo; D'Andrea, Federico
• Is Part Of: Clinical nutrition. Volume 36:Issue 1(2017:Feb.)
• Page Start: 246
• Page End: 252
• Publication Date: 2017-02
• Subjects: Pressure ulcers -- Oral nutritional support -- Healing -- Cost-effectiveness -- Incremental cost-effectiveness ratio; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2015.11.012
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: The Oligo Element Sore Trial has shown that supplementation with a disease-specific nutritional formula enriched with arginine, zinc, and antioxidants improves pressure ulcer (PU) healing in malnourished patients compared to an isocaloric–isonitrogenous support. However, the use of such a nutritional formula needs to be supported also by a cost-effectiveness evaluation. Methods: This economic evaluation – from a local healthcare system perspective – was conducted alongside a multicenter, randomized, controlled trial following a piggy-back approach. The primary efficacy endpoint was the percentage of change in PU area at 8 weeks. The cost analysis focused on: the difference in direct medical costs of local PU care between groups and incremental cost-effectiveness ratio (ICER) of nutritional therapy related to significant study endpoints (percentage of change in PU area and ≥40% reduction in PU area at 8 weeks). Results: Although the experimental formula was more expensive (mean difference: 39.4 Euros; P < 0.001), its use resulted in money saving with respect to both non-nutritional PU care activities (difference, −113.7 Euros; P = 0.001) and costs of local PU care (difference, −74.3 Euros; P = 0.013). Therefore, given its efficacy it proved to be a cost-effective intervention. The robustness of these results was confirmed by the sensitivity analyses. Conclusion: The use of a disease-specific oral nutritional formula not only results in better healing of PUs, but also reduces the costs of local PU care from a local healthcare system perspective.