A Systematic Review of Cost-Effectiveness Studies of Interventions With a Personalized Nutrition Component in Adults

Abstract

Important links between dietary patterns and diseases have been widely applied to establish nutrition interventions. However, knowledge about between-person heterogeneity regarding the benefits of nutrition intervention can be used to personalize the intervention and thereby improve health outcomes and efficiency. We performed a systematic review of cost-effectiveness analyses (CEAs) of interventions with a personalized nutrition (PN) component to assess their methodology and findings. Methods: A systematic search (March 2019) was performed in 5 databases: EMBASE, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar. CEAs involving interventions in adults with a PN component were included; CEAs focusing on clinical nutrition or undernutrition were excluded. The CHEERS checklist was used to assess the quality of CEAs. Results: We identified 49 eligible studies among 1792 unique records. Substantial variation in methodology was found. Most studies (91%) focused only on psychological concepts of PN such as behavior and preferences. Thirty-four CEAs were trial-based, 13 were modeling studies, and 4 studies were both trial-and model-based. Thirty-two studies used qualityadjusted life-year as an outcome measure. Different time horizons, comparators, and modeling assumptions were applied, leading to differences in costs/quality-adjusted life-years. Twenty-eight CEAs (49%) concluded that the intervention was cost-effective, and 75% of the incremental cost-utility ratios were cost-effective given a willingness-to-pay threshold of $50 000 per quality-adjusted life-year. Conclusions: Interventions with PN components are often evaluated using various types of models. However, most PN interventions have been considered cost-effective. More studies should examine the cost-effectiveness of PN interventions that combine psychological and biological concepts of personalization.

Economic Evaluation of Individualized Nutritional Support for Hospitalized Patients with Chronic Heart Failure

“…The strategy of improving patients' nutritional status to improve health and cost outcomes is well-known and gaining evergrowing supportive evidence. In a recent systematic review, Galekop et al identified 53 studies that analyzed the cost-effectiveness of personalized nutrition in patient care [39]. Nearly half of the analyses (49%) concluded that nutritional intervention was cost-effective, and 75% of the incremental cost-utility ratios were cost-effective given a willingness-to-pay threshold of USD 50,000 per quality-adjusted life-year [39].…”

“…In a recent systematic review, Galekop et al identified 53 studies that analyzed the cost-effectiveness of personalized nutrition in patient care [39]. Nearly half of the analyses (49%) concluded that nutritional intervention was cost-effective, and 75% of the incremental cost-utility ratios were cost-effective given a willingness-to-pay threshold of USD 50,000 per quality-adjusted life-year [39]. Other researchers performed a specific value analysis on the use of nutritional support therapy to lower the risk of hospitalacquired infections (HAIs), which are life-threatening and expensive to treat [40].…”

Using the Diffusion of Innovation Theory to Understand the Challenges and Opportunities to Advancing Use of Nutrigenetics in Clinical Practice

“…Although the concept of conducting cost-effectiveness analyses for health innovations was first introduced in 1977 [19], it was not until recently that professional organizations proposed integrating cost-effectiveness/value assessments directly into clinical guidelines [20]. A recent systematic review evaluating the cost-effectiveness of personalized nutrition interventions did not find any studies that included genotype approaches [21]. Lack of economic studies can make it challenging to justify integrating NGx testing within patient care.…”

Socioeconomic assessment of diet on health and quality of life

“…In this context a correct nutrition is one of the cornerstones of preventive and curative medicine (Singh et al , 2017). Moreover, it is believed that better health outcomes can be achieved for each euro spent guaranteeing the population an adequate nutritional intake (Galekop et al , 2021). The report published by the International Obesity Task Force shows that malnutrition in Europe is constantly increasing and, in some areas, it reaches the same percentages registered in the USA (Lobstein et al , 2005).…”