BUDGET IMPACT OF AN ENTERAL FEEDING PUMP DELIVERING THICK FORMULA (IDDSI 2-4) AND HYDRATION TO SUPPORT BLENDED FEEDING IN UNITED KINGDOM PAEDIATRIC HOME ENTERAL NUTRITION
Author(s)
Kristen La Salle, BSc, BAppSci, JD1, Andrew Drake, BSc2, Emily Miller, MBA, BSN, RN3, Luis Cortez Huerta, MSc4, Ernesto M. Nogueira, MBA5.
1Cardinal Health, Melbourne, Australia, 2Cardinal Health, Dorchester, United Kingdom, 3Cardinal Health, Odessa, MO, USA, 4Cardinal Health, Santiago, Chile, 5ValueConnected, The Hague, Netherlands.
1Cardinal Health, Melbourne, Australia, 2Cardinal Health, Dorchester, United Kingdom, 3Cardinal Health, Odessa, MO, USA, 4Cardinal Health, Santiago, Chile, 5ValueConnected, The Hague, Netherlands.
OBJECTIVES: To estimate, from a UK purchaser perspective, the budget impact of an enteral feeding pump delivering thick formula (IDDSI levels 2-4) and hydration, supporting blended feeding, versus standard pumps, for paediatric home enteral nutrition.
METHODS: A cohort budget impact model compared the intervention with the standard-pump pathway, which cannot reliably deliver thick or blended feeds, requiring syringe/gravity bolus workarounds and manual flushing; results may vary by pump. The model (purchaser perspective) counted only purchaser-borne costs: feeding sets, syringe consumables, occlusion management, and the feed cost (prescribed commercial formula vs prescribed home-blended food); the pump is loaned/bundled (£0, identical across arms). Incremental cost was estimated per patient/year and per 1,000 patients (one-year base case; three-year scenario; GBP; no discounting). Inputs: manufacturer pricing, UK unit costs (NHS, PSSRU), published literature, and a UK paediatric cohort; bench testing showed the intervention delivered thick formula within ±10% of programmed volume versus ~22.5% under-delivery for standard pumps. Benefits outside the purchaser's budget (fewer admissions, reduced medications) were qualitative. One-way and scenario sensitivity analyses were conducted; bridged inputs were labelled.
RESULTS: The intervention generated a net purchaser saving of £3,998/patient/year (£4.0M per 1,000), driven by enabling a switch from prescribed commercial formula (£6,485/year) to prescribed home-blended food (£2,315/year); device and consumables were broadly neutral (+£172/patient/year if feed unchanged). A societal scenario adding avoided carer bolus-feeding time increased the saving to £8,174/patient/year. Results were most sensitive to the feed cost.
CONCLUSIONS: From a UK purchaser perspective, the intervention generates net cost savings in paediatric home enteral nutrition, primarily by enabling a switch from prescribed commercial formula to prescribed home-blended food. Further research is warranted on additional cost savings attributable to the symptom improvement achieved with a blended diet.
METHODS: A cohort budget impact model compared the intervention with the standard-pump pathway, which cannot reliably deliver thick or blended feeds, requiring syringe/gravity bolus workarounds and manual flushing; results may vary by pump. The model (purchaser perspective) counted only purchaser-borne costs: feeding sets, syringe consumables, occlusion management, and the feed cost (prescribed commercial formula vs prescribed home-blended food); the pump is loaned/bundled (£0, identical across arms). Incremental cost was estimated per patient/year and per 1,000 patients (one-year base case; three-year scenario; GBP; no discounting). Inputs: manufacturer pricing, UK unit costs (NHS, PSSRU), published literature, and a UK paediatric cohort; bench testing showed the intervention delivered thick formula within ±10% of programmed volume versus ~22.5% under-delivery for standard pumps. Benefits outside the purchaser's budget (fewer admissions, reduced medications) were qualitative. One-way and scenario sensitivity analyses were conducted; bridged inputs were labelled.
RESULTS: The intervention generated a net purchaser saving of £3,998/patient/year (£4.0M per 1,000), driven by enabling a switch from prescribed commercial formula (£6,485/year) to prescribed home-blended food (£2,315/year); device and consumables were broadly neutral (+£172/patient/year if feed unchanged). A societal scenario adding avoided carer bolus-feeding time increased the saving to £8,174/patient/year. Results were most sensitive to the feed cost.
CONCLUSIONS: From a UK purchaser perspective, the intervention generates net cost savings in paediatric home enteral nutrition, primarily by enabling a switch from prescribed commercial formula to prescribed home-blended food. Further research is warranted on additional cost savings attributable to the symptom improvement achieved with a blended diet.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE364
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Gastrointestinal Disorders, Nutrition, Pediatrics