OBJECTIVES: In the hospital setting, the management of disease-related malnutrition via oral nutritional supplements (ONS) improves the nutritional status of hospitalized patients and reduces their management costs. These beneficial effects mainly depend on patients’ adherence to ONS prescription, which can be enhanced with highly concentrated ONS. This research aims to quantify the incremental benefit of highly concentrated vs traditional ONS from a Spanish hospital perspective.

METHODS: A health economic model was developed to study the impact of using high protein concentration ONS (hp-ONS, ~0.16 g/ml) instead of traditional ONS (t-ONS, ~0.10 g/ml) within a large hospital in Spain (1,200 hospital beds). ONS were assumed to be administered to patients who were either malnourished at hospital admission or at risk of developing malnutrition during their hospital stay. Prevalence and risk of malnutrition, and changes to patients’ nutritional status during their hospitalization when consuming ONS, were referenced from Spanish literature. Mean ONS adherence was referenced from SLR and was higher for hp-ONS vs t-ONS. A linear relationship was assumed between adherence and nutritional status improvement during the hospitalization course. In line with the Spanish decree, which reimburses ONS according to caloric content, hp-ONS and t-ONS daily costs were omitted (assuming they are similar).

RESULTS: Out of 1,200 modelled patients, 676 used ONS during their hospital stay. 345 patients were malnourished at time of discharge in the hp-ONS scenario vs 378 patients in the t-ONS scenario (-8.7%). In the hp-ONS scenario, the average length of stay and the total number of hospital days were reduced by 1.2% (1.9% if focusing on ONS-consuming patients). The hospital budget saving was 127K€.

CONCLUSIONS: Results of the health economic model confirm that hp-ONS offer additional value over traditional nutrition by positively impacting patients' nutritional status at discharge and reducing length of stay and hospitalization costs.