OBJECTIVES: Several published studies have demonstrated that the supplementation of Omegaven® has better clinical outcomes in Systemic Inflammatory Response Syndrome (SIRS) or elective major surgery patients treated in Intensive Care Units (ICUs),with shorter average lengths of stay in  hospital and reduced fatality rate , as compared to standard total parenteral nutrition (TPN) regimens. The objective of the simulation study was to evaluate the CE of the supplementation of Omegaven® vs standard TPN in the Chinese setting. METHODS: A discrete event simulation (DES) model was constructed to compare the nutritional strategies in elective surgery and SIRS patients, by combining outcomes recorded in 79 elective major surgical patients and 56 SIRS patients receiving TPN in the surgical ICU of a tertiary hospital in Shanghai. Omegaven® efficacy estimates from a random effects Bayesian meta-analysis on Chinese and international clinical trials, and Chinese cost data collected in the same hospital, comprising ICU and general ward costs, and the cost for TPN. RESULTS: Omegaven® showed being effective in reducing fatality rate and total hospital length of stay (- 2.8 and -2.5 days) in both surgical and SIRS patients. In the SIRS group, the treatment could avoid 5.7 deaths every 100 patients. Reduced hospitalizations costs completely offset treatment cost, with a saving associated with Omegaven® of about 8,000 and 6,800 RMB in surgical and SIRS patients, respectively. CONCLUSIONS: The supplementation of Omegaven® can be considered dominant versus standard TPN, as the results of DES show that a mean increase of the effectiveness is associated with a mean decrease of the costs.