OBJECTIVES : Adequate nutritional therapy is essential for recovery from critical illness. Nutritional requirement varies in different patients and varies daily in a single patient. The objective of this study is to determine the cost-effectiveness of Enterex® IMX vs standard therapy (not offering any specialized nutrition intervention containing arginine) in the treatment neurocritical patients in the intensive care unit (ICU) in Mexico.

METHODS : A cost-effectiveness analysis was conducted using a Markov model to assess the efficacy of the treatments (Enterex® IMX vs standard therapy), defined as mortality and length of stay in the ICU, the costs evaluated included the standard therapy, specialized nutrition intervention, only for the Enterex® IMX arm, and the ICU costs per day. A probabilistic sensitivity analysis (first order Monte Carlo Simulation, 1,000 interactions) was developing to assess the robustness of the case base results. The time horizon is 30 days,.so noo discount rate was considered. The costs are presented in USD. This study was conducted from the institutional perspective.

RESULTS : The results indicates that Enterex® IMX is an alternative less costly when compared to standard therapy, $4,427.08 ($3,984.38-$4,869.79) vs $2,239.58, respectively. So Enterex® HPT generates $2,187.50 savings per patient. On the other hand, neurocritical patients using Enterex® IMX were less day in the UCI (15.5 vs 19.0 days), and the mortality rate was lower (6.3 vs 1.1) than with standard therapy. The cost-effectiveness base case analysis indicates that Enterex® IMX is a dominant alternative (more effectiveness, less cost) in both outcomes measured. For a cohort of 1,000 patients the potential savings are $2,187,500.00 USD by using Enterex® IMX.

CONCLUSIONS : Critical illness renders a patient prone to malnutrition. In neurocriticall ill patients, the use of an enteral formula, Enterex® IMX, has shown important nutritional and clinical benefits as well as savings for the public sector en México.