Analysis of the health economic impact of medical nutrition in the Netherlands

Objective:A health economic analysis was performed to assess the cost-effectiveness of oral nutritional supplements (ONS), being a medical nutrition product, in the Netherlands.Methods:This analysis is based on a comparison of the use of ONS versus no use of ONS in patients undergoing abdominal surgery. The costs and benefits of the two treatment strategies were assessed using a linear decision analytical model reflecting treatment patterns and outcomes in abdominal surgery. The incremental cost difference was based on costs associated with ONS and hospitalization. Clinical probabilities and resource utilization were based on clinical trials and published literature; cost data were derived from official price tariffs.Results:The use of ONS reduces the costs with a € 252 (7.6%) cost saving per patient. The hospitalization costs reduce from € 3,318 to € 3,044 per patient, which is a 8.3% cost saving and corresponds with 0.72 days reduction in length of stay. The use of ONS would lead to an annual cost saving of a minimum of € 40.4 million per year. Sensitivity analyses showed that the use of ONS remains cost saving compared with no use of ONS. A threshold analysis on the length of stay shows that at 0.64 days, the use of ONS is still cost-effective, which is an unrealistic value.Conclusions:This analysis shows that the use of medical nutrition, ONS in this case, is a cost-effective treatment in the Netherlands and is dominant over standard care without medical nutrition: it leads to cost savings and a higher effectiveness.

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