Economic and Clinical Insights Into Oral Nutritional Supplementation in Oncology: A Brazilian Real-World Study
Author(s)
Joao Paulo Dos Reis Neto, PhD, MD1, JULIANA BUSCH, MD2.
1ceo, Diretor-Presidente da Capesesp, Rio de Janeiro, Brazil, 2CAPESESP, Rio de Janeiro, Brazil.
1ceo, Diretor-Presidente da Capesesp, Rio de Janeiro, Brazil, 2CAPESESP, Rio de Janeiro, Brazil.
OBJECTIVES: Cancer patients and survivors need appropriate nutritional support in addition to surgical or pharmacological treatment. The purpose of this study is to analyze oral nutritional supplements (ONS) utilization on each tumor stage and site.
METHODS: Retrospective study using administrative data from January/2019 to December/2024. Patients’ cancer undergoing oncological therapy were evaluated for the use of ONS. Data included TNM stage at diagnosis and treatment initiation. Analysis was carried out separately for stages (I, II, III and IV) and by site. Data includes demographics, comorbidities, healthcare resource utilization (HCRU), and costs. Chi-square and Fisher’s exact and Student’s tests for categorical/continuous measures were used. Statistical significance for p<0.05.
RESULTS: Of 60,666 beneficiaries (53.3 years, 59.5% female), 1,816 eligible (69.8 years; 56.3% female) and 27.3% underwent ONS. ONS was used in 20.9% for early-stages (I/II) and 37.9% for late-stages (33.6% III, 40.7% IV) (p<0.001). The tumors with the highest use of ONS: pancreas (55.2%), ovary (50.0%), liver/biliary tract (44.2%), colon/rectum (43.1%), gastric/esophageal (40.9%), lung (34.9%) and others, below 30%. Annual rates of procedures: visits=8.3, emergency room visits=2.7, tests=114.8 and 2.0 for hospitalizations. Average length of hospitalization: 11.7 days. Annualized healthcare costs associated were U$ 39,198/patient, being 40.3% chemotherapy/radiotherapy and 3.9% all types of nutritional support (14.6% ONS).
CONCLUSIONS: Malnutrition is a frequent and costly complication in cancer care, especially among patients with advanced disease and nutritionally demanding tumor sites. This real-world analysis reveals that ONS use is more common in high-risk groups but often initiated late in the care continuum. Despite representing a small share of total healthcare costs, timely and systematic nutritional intervention - including early ONS initiation - may be a cost-effective strategy to improve treatment adherence, reduce complications, and optimize both clinical outcomes and resource utilization in oncology.
METHODS: Retrospective study using administrative data from January/2019 to December/2024. Patients’ cancer undergoing oncological therapy were evaluated for the use of ONS. Data included TNM stage at diagnosis and treatment initiation. Analysis was carried out separately for stages (I, II, III and IV) and by site. Data includes demographics, comorbidities, healthcare resource utilization (HCRU), and costs. Chi-square and Fisher’s exact and Student’s tests for categorical/continuous measures were used. Statistical significance for p<0.05.
RESULTS: Of 60,666 beneficiaries (53.3 years, 59.5% female), 1,816 eligible (69.8 years; 56.3% female) and 27.3% underwent ONS. ONS was used in 20.9% for early-stages (I/II) and 37.9% for late-stages (33.6% III, 40.7% IV) (p<0.001). The tumors with the highest use of ONS: pancreas (55.2%), ovary (50.0%), liver/biliary tract (44.2%), colon/rectum (43.1%), gastric/esophageal (40.9%), lung (34.9%) and others, below 30%. Annual rates of procedures: visits=8.3, emergency room visits=2.7, tests=114.8 and 2.0 for hospitalizations. Average length of hospitalization: 11.7 days. Annualized healthcare costs associated were U$ 39,198/patient, being 40.3% chemotherapy/radiotherapy and 3.9% all types of nutritional support (14.6% ONS).
CONCLUSIONS: Malnutrition is a frequent and costly complication in cancer care, especially among patients with advanced disease and nutritionally demanding tumor sites. This real-world analysis reveals that ONS use is more common in high-risk groups but often initiated late in the care continuum. Despite representing a small share of total healthcare costs, timely and systematic nutritional intervention - including early ONS initiation - may be a cost-effective strategy to improve treatment adherence, reduce complications, and optimize both clinical outcomes and resource utilization in oncology.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD69
Topic
Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Nutrition, Oncology