Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing

Emanuele Cereda, Catherine Klersy, Manuela Andreola, Roberto Pisati, Jos M G A Schols, Riccardo Caccialanza, Federico D'Andrea

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
JournalClinical Nutrition
DOIs
Publication statusAccepted/In press - Mar 30 2015

Keywords

  • Cost-effectiveness
  • Healing
  • Incremental cost-effectiveness ratio
  • Oral nutritional support
  • Pressure ulcers

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nutrition and Dietetics

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