HEALTH AND ECONOMIC IMPACT OF INCREASING ENTERAL NUTRITION USE IN CRITICALLY ILL PATIENTS: DEVELOPMENT OF A HOSPITAL-BASED VALUE COMMUNICATION TOOL IN ITALY
Author(s)
Sara Marques, MSc1, Marialaura Scarcella, MD2, Aditya Dular, MBA3, Luca Cordaro, MSc4, Tanushree Chaudhary Pavithran, MSc5, Anamaria-Vera Olivieri, MSc6.
1IQVIA, Oeiras, Portugal, 2University of Study Perugia, Spoleto, Italy, 3Nutricia - Danone, Eschborn, Germany, 4Danone Nutricia S.p.A., Milano, Italy, 5IQVIA, Trivandrum, India, 6Commercial Solutions Excellence Centres, IQVIA, Basel, Switzerland.
1IQVIA, Oeiras, Portugal, 2University of Study Perugia, Spoleto, Italy, 3Nutricia - Danone, Eschborn, Germany, 4Danone Nutricia S.p.A., Milano, Italy, 5IQVIA, Trivandrum, India, 6Commercial Solutions Excellence Centres, IQVIA, Basel, Switzerland.
OBJECTIVES: To quantify the clinical, healthcare resource use, and economic impact of increasing the uptake of enteral nutrition (EN) versus current use in critically ill adults requiring medical nutrition in hospital settings, using a flexible, user-adaptable health-economic value communication tool (HE‑VCT).
METHODS: A de-novo comparative analysis assessed current practice versus increased EN uptake. Outcomes were estimated at patient and population levels, including infections, complications, healthcare resource use, and costs. The hospital‑perspective analysis focused on critically ill patients requiring medical nutrition, followed across intensive care unit (ICU) and ward settings in one year. Events, resource use, and costs - sourced from a pragmatic literature review - were applied per index hospitalization, anchored to length of stay (LOS) with daily accrual. Key inputs included nutrition modality (EN, parenteral nutrition [PN], EN+PN), ICU and ward LOS, mechanical ventilation days, infection and gastrointestinal complication rates, readmissions, staff time, and costs. Incremental differences between scenarios quantified the value of increasing EN use.
RESULTS: A hypothetical ~20% increase in EN utilization (from 40%) was projected to reduce healthcare resource use and improve clinical outcomes. Estimated reductions included 3.6 ICU bed-days and 25.2 ward bed-days per 100 patients annually. Staff time for initiation and monitoring of nutrition support was reduced by 47.7 hours per 100 patients. Increasing EN use may be associated with reductions of 3.1 general infections and 0.9 bloodstream infections per 1,000 patient‑years, with modest increases in mild gastrointestinal events (diarrhea, vomiting). Economic outcomes indicated potential hospital cost savings (ICU and ward) of €585 per patient annually, and €56 mil. nationally across an estimated population of 95,570 patients requiring medical nutrition.
CONCLUSIONS: Increasing EN uptake in critically ill is associated with improved clinical outcomes, reduced resource utilization, and cost savings. The HE‑VCT provides a flexible, evidence-based framework to inform hospital decision-making and procurement in settings with limited local data.
METHODS: A de-novo comparative analysis assessed current practice versus increased EN uptake. Outcomes were estimated at patient and population levels, including infections, complications, healthcare resource use, and costs. The hospital‑perspective analysis focused on critically ill patients requiring medical nutrition, followed across intensive care unit (ICU) and ward settings in one year. Events, resource use, and costs - sourced from a pragmatic literature review - were applied per index hospitalization, anchored to length of stay (LOS) with daily accrual. Key inputs included nutrition modality (EN, parenteral nutrition [PN], EN+PN), ICU and ward LOS, mechanical ventilation days, infection and gastrointestinal complication rates, readmissions, staff time, and costs. Incremental differences between scenarios quantified the value of increasing EN use.
RESULTS: A hypothetical ~20% increase in EN utilization (from 40%) was projected to reduce healthcare resource use and improve clinical outcomes. Estimated reductions included 3.6 ICU bed-days and 25.2 ward bed-days per 100 patients annually. Staff time for initiation and monitoring of nutrition support was reduced by 47.7 hours per 100 patients. Increasing EN use may be associated with reductions of 3.1 general infections and 0.9 bloodstream infections per 1,000 patient‑years, with modest increases in mild gastrointestinal events (diarrhea, vomiting). Economic outcomes indicated potential hospital cost savings (ICU and ward) of €585 per patient annually, and €56 mil. nationally across an estimated population of 95,570 patients requiring medical nutrition.
CONCLUSIONS: Increasing EN uptake in critically ill is associated with improved clinical outcomes, reduced resource utilization, and cost savings. The HE‑VCT provides a flexible, evidence-based framework to inform hospital decision-making and procurement in settings with limited local data.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE365
Topic
Economic Evaluation, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Budget Impact Analysis
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Nutrition