Preoperative Immunonutrition: Cost–Benefit Analysis

Braga, Marco; Rocchetti, Simona

doi:10.1007/978-1-60761-308-4_20

Cited by 8 publications

(12 citation statements)

References 15 publications

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“…The budget impact analyses showed similar results 6,22–26. In a few studies, cost-effectiveness results were also presented, and they were also in favor of ONS 22,23,25.…”

Section: Resultssupporting

confidence: 53%

“…These analyses proved that medical nutrition offers value for money in these settings. Furthermore, in all studies related to IN, the standard diet was chosen as the comparator, which could be interpreted as a standard tube feeding formula (and, hence, as medical nutrition as well) 6,22,23,25,26. Most of the time, medical nutrition was more effective and cost-saving and, therefore, dominant from a health economic perspective.…”

Section: Discussionmentioning

confidence: 99%

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Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

Walzer¹,

Droeschel²,

Nuijten³

et al. 2014

CEOR

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BackgroundHealth care decision-makers have begun to realize that medical nutrition plays an important role in the delivery of care, and it needs to be seen as a sole category within the overall health care reimbursement system to establish the value for money. Indeed, improving health through improving patients’ nutrition may contribute to the cost-effectiveness and financial sustainability of health care systems. Medical nutrition is regulated by a specific bill either in Europe or in the United States, which offers specific legislations and guidelines (as provided to patients with special nutritional needs) and indications for nutritional support. Given that the efficacy of medical nutrition has been proven, one can wonder whether the heterogeneous nature of its coverage/reimbursement across countries might be due to the lack of health-related economic evidence or value-for-money of nutritional interventions. This paper aims to address this knowledge gap by performing a systematic literature review on health economics evidence regarding medical nutrition, and by summarizing the results of these publications related to the value for money of medical nutrition interventions.MethodsA systematic literature search was initiated and executed based on a predefined search protocol following the population, intervention, comparison, and outcomes (PICO) criteria. Following the systematic literature search of recently published literature on health economics evidence regarding medical nutrition, this study aims to summarize the results of those publications that are related to the value for money of medical nutrition interventions. The evaluations were conducted by analyzing different medical nutrition according to their indications, the economic methodology or perspective adopted, the cost source and utility measures, selected efficiency measures, as well as the incremental cost-effectiveness ratio.ResultsA total of 225 abstracts were identified for the detailed review, and the data were entered into a data extraction sheet. For the abstracts that finally met the predefined inclusion criteria (n=53), full-text publications were obtained via PubMed, subito, or directly via each journal’s Webpage for further assessment. After a detailed review of the full text articles, 34 publications have been qualified for a thorough data extraction procedure. When differentiating the resulting articles in terms of their settings, 20 studies covered inpatients, whereas 14 articles covered outpatients, including patients in community centers. When reviewing the value-for-money evaluations, the indications showed that the different results were mostly impacted by the different perspectives adopted and the comparisons that were made. In order to draw comprehensive conclusions, the results were split according to the main indications and diseases.DiscussionThe systematic literature search has shown that there is not only an interest in health economics and its application in medical nutrition, but that there is a lot of ongoing research in ...

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“…The budget impact analyses showed similar results 6,22–26. In a few studies, cost-effectiveness results were also presented, and they were also in favor of ONS 22,23,25.…”

Section: Resultssupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

Walzer¹,

Droeschel²,

Nuijten³

et al. 2014

CEOR

View full text Add to dashboard Cite

show abstract

“…Most questions could be answered, and the paper included all relevant information. An important difference between this review and the one published by Braga and Rocchetti21 in 2011 was that Canegelosi et al also searched the gray literature and reported both included and excluded studies.…”

Section: Resultsmentioning

confidence: 97%

Health economic analyses in medical nutrition: a systematic literature review

Walzer¹,

Droeschel²,

Nuijten³

et al. 2014

CEOR

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BackgroundMedical nutrition is a specific nutrition category either covering specific dietary needs and/or nutrient deficiency in patients or feeding patients unable to eat normally. Medical nutrition is regulated by a specific bill in Europe and in the US, with specific legislation and guidelines, and is provided to patients with special nutritional needs and indications for nutrition support. Therefore, medical nutrition products are delivered by medical prescription and supervised by health care professionals. Although these products have existed for more than 2 decades, health economic evidence of medical nutrition interventions is scarce. This research assesses the current published health economic evidence for medical nutrition by performing a systematic literature review related to health economic analysis of medical nutrition.MethodsA systematic literature search was done using standard literature databases, including PubMed, the Health Technology Assessment Database, and the National Health Service Economic Evaluation Database. Additionally, a free web-based search was conducted using the same search terms utilized in the systematic database search. The clinical background and basis of the analysis, health economic design, and results were extracted from the papers finally selected. The Drummond checklist was used to validate the quality of health economic modeling studies and the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist was used for published systematic reviews.ResultsFifty-three papers were identified and obtained via PubMed, or directly via journal webpages for further assessment. Thirty-two papers were finally included in a thorough data extraction procedure, including those identified by a “gray literature search” utilizing the Google search engine and cross-reference searches. Results regarding content of the studies showed that malnutrition was the underlying clinical condition in most cases (32%). In addition, gastrointestinal disorders (eg, surgery, cancer) were often analyzed. In terms of settings, 56% of papers covered inpatients, whereas 14 papers (44%) captured outpatients, including patients in community centers. Interestingly, in comparison with the papers identified overall, very few health economic models were found. Most of the articles were modeling analyses and economic trials in different design settings. Overall, only eight health economic models were published and were validated applying the Drummond checklist. In summary, most of the models included were carried out to quite a high standard, although some areas were identified for further improvement. Of the two systematic health economic reviews identified, one achieved the highest quality score when applying the AMSTAR checklist.ConclusionThe reasons for finding only a few modeling studies but quite a large number of clinical trials with health economic endpoints, might be different. Until recently, health economics has not been required for reimbursement or coverage decisions concerning medical nutriti...

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“…5 Therefore, the reason for this letter is to encourage the Spanish Association of Surgeons (Asociació n Españ ola de Cirujanos) to initiate a similar process to transmit to surgeons, responsible health care administrators and ministries that these practices are not only in the patients' best interest, but also result in proven medical and economic benefits. [6][7][8] The French situation in this matter is a clear example of how scientific evidence can come to influence clinical practice. r e f e r e n c e s…”

Section: Inmunonutrició N Perioperatoriamentioning

confidence: 99%