OBJECTIVES

To compare, from the payer’s perspective, the cost between a Ready to Use (RTU) Olive Oil-Based Parenteral Nutrition with and without Electrolytes and Subrogate Compounded Parenteral Nutrition (SCPN) among critically ill patients requiring Parenteral Nutrition (PN) where Oral or Enteral Nutrition is contraindicated.

METHODS

Based on the results of a Delphi Panel that included 7 Nutritionists working on State, Regional and Specialty Hospitals in Mexico, 3 types of patients were analyzed to determine their nutritional intakes per week:

Patient 1: 50 years old male patient with 22 kg/m² BMI with cranioencephalic trauma.

Patient 2: 45 years old diabetic female with abdominal trauma receiving 0.5 units/kg/day of NPH insulin.

Patient 3: 65 years old male patient with major cardiac surgery with a BMI of 40 kg/m², is suspected to require dialysis.

For each patient profile, the Delphi Panel determined the nutritional intakes that leads to the cost of elaboration of compounded Parenteral Nutrition per patient type.

Costs were determined by incorporate the individual components in the elaboration of SCPN published on national tenders by the Social Security Mexican Institute (IMSS) plus the elaboration cost derived from the subrogate service, In the other hand, the cost of RTU 2 liter bags were used for patients type 1 and 3, for patient type 2 the cost of 1.5 liters bag was used.

This model used FIX a conversion rate of $19.3708 MXN/USD.

RESULTS

RTU results in a cost saving alternative in all type of patients, with savings of US $689.52 in type 1 patient, $779.77 in type 2 patient and $670.05 in type 3 patient, with average savings of 64% respect SCPN ($404.13 vs $1117.24.

CONCLUSIONS

From the Mexican payer perspective, the adoption of RTU in patients requiring PN is a cost saving alternative in different common patient profiles.