title: Cost and effectiveness of omega-3 fatty acid supplementation in Chinese ICU patients receiving parenteral nutrition.
abstract: OBJECTIVE
  Clinical evidence supports the use of omega-3 polyunsaturated fatty acid (PUFA)-enriched lipid emulsions in place of standard lipid emulsions in parenteral nutrition (PN) for intensive care unit (ICU) patients, but uptake may be limited by higher costs. We compared clinical and economic outcomes for these two types of lipid emulsion in the Chinese ICU setting.
  
  
  METHODS
  We developed a pharmacoeconomic discrete event simulation model, based on efficacy data from an international meta-analysis and patient characteristics, resource consumption, and unit costs from a Chinese institutional setting. Probabilistic sensitivity analyses were undertaken to assess the effects of uncertainty around input parameters. Model predictive validity was assessed by comparing results with data observed in a patient subset not used in the modeling.
  
  
  RESULTS
  The model predicted that omega-3 PUFA-enriched emulsion (Omegaven(®) 10% fish oil emulsion) would dominate standard lipid emulsions, with better clinical outcomes and lower overall health care costs (mean savings ~10,000 RMB), mainly as a result of faster recovery and shorter hospital stay (by ~6.5 days). The external validation process confirmed the reliability of the model predictions.
  
  
  CONCLUSIONS
  Omega-3 PUFA-enriched lipid emulsions improved clinical outcome and decreased overall costs in Chinese ICU patients requiring PN.
authors.affiliation: Department of General Surgery, Fudan University, Shanghai, People's Republic of China.
authors.forename: Guo Hao
authors.initials: GH
authors.lastname: Wu
authors.affiliation: Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Jian
authors.initials: J
authors.lastname: Gao
authors.affiliation: Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Chun Yan
authors.initials: CY
authors.lastname: Ji
authors.affiliation: AdRes Health Economics and Outcomes Research, Piazza Carlo Emanuele II, Torino, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pradelli
authors.affiliation: Department of General Surgery, Fudan University, Shanghai, People's Republic of China.
authors.forename: Qiu Lei
authors.initials: QL
authors.lastname: Xi
authors.affiliation: Department of General Surgery, Fudan University, Shanghai, People's Republic of China.
authors.forename: Qiu Lin
authors.initials: QL
authors.lastname: Zhuang
keywords: ICU patients; external validation; length of hospital stay; microsimulation; omega-3 PUFA-enriched lipids; total costs