A Systematic Review of Health Economic Evaluations of Oral Nutritional Supplements as a Single-Component or Multi-Component Intervention in Older Adults With or at Risk of Malnutrition

Speaker(s)

Desai A1, Dong OM2, Gautier S3, Johnson T4, Wong A5, Osman AMY6, Harvey J7, Tran TH8, Holladay Ford DM9, Kerr KW10, Aggarwal A11, Mauskopf J12
1Nestlé Healthcare Nutrition, Inc, Bridgewater, NJ, USA, 2RTI Health Solutions, Research Triangle Park, NC, USA, 3ISPOR - The Professional Society for Health Economics and Outcomes Research, Lawrenceville, NJ, USA, 4Rush University, Chicago, IL, USA, 5Changi General Hospital, Simei, Singapore, 6International Islamic University Malaysia, Kuantan, Pahang Darul Makmour, Malaysia, 7Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA, 8University of Maryland School of Pharmacy, Baltimore, MD, USA, 9Center for Improving Value in Health Care, Denver, CO, USA, 10Abbott Nutrition, Columbus, OH, USA, 11IQVIA, Gurgaon, DL, India, 12RTI International, Research Triangle Park, NC, USA

Presentation Documents

OBJECTIVES: This systematic literature review summarizes key findings from health economic evaluations in older adults with or at risk of malnutrition receiving oral nutrition supplement (ONS) interventions.

METHODS: This review utilized six electronic databases (PubMed, Embase, EconLit, CINAHL, Cochrane, Scopus) to identify health economic evaluations comparing ONS versus any comparators among older adults published between January 2014-February 2024. Inclusion criteria were publication in English, full text, and population with mean age ≥60 years. The Consolidated Health Economic Evaluation Reporting Standards checklist informed data extraction and reporting quality. Methodological quality of studies was assessed using the Drummond 10-item checklist. This study was registered with PROSPERO (CRD42023459161).

RESULTS: Of the 1,459 records identified and screened, 12 studies met the inclusion criteria (4 cost-effectiveness analyses [CEA], 2 cost-utility analyses [CUA], 3 budget-impact analyses [BIA], 1 cost-minimization analysis, 1 CEA plus CUA, 1 BIA plus CEA). Studies were conducted in hospital settings (n=6) in different countries (n=7), had time horizons ≤6 months (n=10), were trial-based (n=8), had usual care as comparators (n=10), and included both healthcare and intervention costs (n=11). Across all studies, ONS intervention costs were low, resulting in lower or slightly higher total healthcare costs (e.g., ONS cost of €189 and total healthcare costs €191 lower at 18 weeks vs. comparator). In 11 studies, ONS interventions had higher overall patient health outcomes vs. comparators (e.g., significantly faster pressure ulcer healing at 8 weeks). In 6 studies that reported quality-adjusted life-years (QALYs), ONS interventions resulted in slightly higher QALYs vs. comparators (e.g., 3-month incremental QALY gain of 0.011). All studies concluded ONS intervention was cost-effective or cost saving.

CONCLUSIONS: ONS improves patient outcomes among at-risk or malnourished older adults in hospital and community settings at minimal costs to healthcare systems. Future studies with longer time horizons are needed to characterize longer-term benefits and costs of ONS interventions.

Code

EE335

Topic

Economic Evaluation, Study Approaches

Topic Subcategory

Budget Impact Analysis, Cost-comparison, Effectiveness, Utility, Benefit Analysis, Literature Review & Synthesis, Trial-Based Economic Evaluation

Disease

Geriatrics, Nutrition