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

E. Cereda, C. Klersy, M. Andreola, R. Pisati, J. M. Schols, R. Caccialanza, F. D'Andrea, OligoElement Sore Trial (OEST) Study Group

Research output: Contribution to journalArticle

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
Pages (from-to)246-252
Number of pages7
JournalClinical Nutrition
Volume36
Issue number1
DOIs
Publication statusPublished - Feb 1 2017

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Nutritional Support
Pressure Ulcer
Cost-Benefit Analysis
Costs and Cost Analysis
Delivery of Health Care
Arginine
Zinc
Randomized Controlled Trials
Antioxidants

Keywords

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Antioxidants/administration & dosage/economics
  • Arginine/administration & dosage/economics
  • Cost-Benefit Analysis
  • Dietary Supplements/economics
  • Endpoint Determination
  • Female
  • Humans
  • Male
  • Malnutrition/drug therapy/economics
  • Pressure Ulcer/drug therapy/economics
  • Wound Healing/drug effects
  • Zinc/administration & dosage/economics
  • Cost-effectiveness
  • Healing
  • Incremental cost-effectiveness ratio
  • Oral nutritional support
  • Pressure ulcers

Cite this

Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing. / Cereda, E.; Klersy, C.; Andreola, M.; Pisati, R.; Schols, J. M.; Caccialanza, R.; D'Andrea, F.; Group, OligoElement Sore Trial (OEST) Study.

In: Clinical Nutrition, Vol. 36, No. 1, 01.02.2017, p. 246-252.

Research output: Contribution to journalArticle

Cereda, E. ; Klersy, C. ; Andreola, M. ; Pisati, R. ; Schols, J. M. ; Caccialanza, R. ; D'Andrea, F. ; Group, OligoElement Sore Trial (OEST) Study. / Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing. In: Clinical Nutrition. 2017 ; Vol. 36, No. 1. pp. 246-252.
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T1 - Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing

AU - Cereda, E.

AU - Klersy, C.

AU - Andreola, M.

AU - Pisati, R.

AU - Schols, J. M.

AU - Caccialanza, R.

AU - D'Andrea, F.

AU - Group, OligoElement Sore Trial (OEST) Study

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N2 - 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.

AB - 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.

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KW - Dietary Supplements/economics

KW - Endpoint Determination

KW - Female

KW - Humans

KW - Male

KW - Malnutrition/drug therapy/economics

KW - Pressure Ulcer/drug therapy/economics

KW - Wound Healing/drug effects

KW - Zinc/administration & dosage/economics

KW - Cost-effectiveness

KW - Healing

KW - Incremental cost-effectiveness ratio

KW - Oral nutritional support

KW - Pressure ulcers

U2 - S0261-5614(15)00332-5 [pii]

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JF - Clinical Nutrition

SN - 0261-5614

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