The economic value of enteral medical nutrition in the management of disease-related malnutrition: a systematic review.
Economic evaluations for medical nutrition, such as oral nutritional supplements (ONS), are relatively uncommon compared with other health technologies, and represent an area that has not been reviewed so far. In this systematic review, economic evaluations of enteral medical nutrition in the management of disease-related malnutrition (DRM) were reviewed and qualified to estimate the economic value. Initially, 481 studies were found, of which 37 full-text articles were assessed for eligibility and were rated on their quality using the Quality of Health Economic Studies (QHES) instrument. The final review focused on the high QHES quality economic evaluation studies. As both the studied medical nutrition intervention and the form of the economic evaluation varied, a quantitative synthesis (meta-analysis) was not attempted but a critical analysis and comparison of the individual study results were performed. ONS was the most studied intervention, covering several patient populations and different health care settings. Outcomes included cost savings (n = 3), no significant extra costs per unit of clinical and/or functional improvement (n = 1), or significantly higher costs per unit of clinical and/or functional improvement but still cost-effective for the used threshold (n = 4). This review shows that the use of enteral medical nutrition in the management of DRM can be efficient from a health economic perspective.
School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands. Electronic address: k.freyer@maastrichtuniversity.nl.
Karen
K
Freijer
Department of Epidemiology, School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands.
Martijn J L
MJ
Bours
Ars Accessus Medica, Jisp, The Netherlands.
Mark J C
MJ
Nuijten
Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, The Netherlands; Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands.
Marten J
MJ
Poley
Department of Health Services Research (Focusing on Chronic Care and Ageing), School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Judith M M
JM
Meijers
Department of Health Services Research (Focusing on Chronic Care and Ageing), School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Ruud J G
RJ
Halfens
Department of General Practice and Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Jos M G A
JM
Schols
D017046:Cost Savings; D003362:Cost-Benefit Analysis; D019587:Dietary Supplements; D004750:Enteral Nutrition / Q000191:economics*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D044342:Malnutrition / Q000191:economics / Q000628:therapy*; D015596:Nutrition Assessment
Systematic review; costs; disease-related malnutrition; economic value; medical nutrition; oral nutritional supplements