OBJECTIVES: To characterize reimbursement policies for medical nutrition (MN) technologies in 14 countries: Australia, Belgium, Brazil, Canada, China, France, the Netherlands, Germany, Italy, Japan, Singapore, Spain, the United Kingdom, and the United States.

METHODS: Data sources for healthcare policies included published literature and online sources. ISPOR’s Nutrition Economics Special Interest Group developed a data collection form to guide data extraction. Extracted data included: 1.) reimbursement coverage for four specific MN technologies (i.e., complete enteral formulas, non-complete enteral formulas, enteral tube feeding formulas, oral nutrition supplements) 2.) year of reimbursement policy establishment and updates, and 3.) presence of a formal Health Technology Assessment (HTA) for MN technologies. At least one researcher was assigned to each country to extract data and at least one reviewer then evaluated the data for accuracy. Disagreements were arbitrated by a third reviewer. Data were analyzed using descriptive statistics.

RESULTS: Reimbursement coverage of MN technologies varied across countries, and with the exception of the United Kingdom, France and the Netherlands, all other countries limited coverage to only specific formulations of products, regardless if clinical benefit was demonstrated. The year that reimbursement policies were established varied across countries (1984-2017). Since establishment of reimbursement policies, eight countries have not made any policy updates, three countries have made policy updates once, and four countries make policy updates regularly. Only France and Brazil have a formal HTA process for MN technologies.

CONCLUSIONS: The majority of countries have limited MN reimbursement, have not made updates to reimbursement policies, and lack HTA for MN technologies. This lack of reimbursement coverage may lead to suboptimal access to MN technologies where they are indicated to manage nutrition-related disorders and conditions, with the potential of negatively impacting patient and healthcare system outcomes.