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Nutrients. 2018 Feb 22;10(2). pii: E246. doi: 10.3390/nu10020246.

Cost-Effectiveness of a Specialized Oral Nutritional Supplementation for Malnourished Older Adult Patients in Spain.

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Servicio de Endocrinología y Nutrición, Complejo Asistencial Universitario de León, Altos de Nava, 24071 León, Spain.
Oblikue Consulting, Carrer del Comte d'Urgell 240 2ºD, 08036 Barcelona, Spain.
Health Economics and Outcomes Research, Abbott Nutrition R&D, Building ES1 East 2900 Easton Square Place, Columbus, OH 43219, USA.
Scientific Affairs & Training, Abbott Nutrition International, Abbott Laboratories, S.A., Avenida de Burgos 91, 28050 Madrid, Spain.
Servicio de Endocrinología y Nutrición, Hospital Universitario Miguel Servet, Paseo Isabel la Católica 1-3, 50009 Zaragoza, Spain.
Instituto de Investigación Sanitaria Aragón (IIS-Aragón), Hospital Universitario Miguel Servet, Paseo Isabel la Católica 1-3, 50009 Zaragoza, Spain.


Malnutrition has been related to prolonged hospital stays, and to increases in readmission and mortality rates. In the NOURISH (Nutrition effect On Unplanned Readmissions and Survival in Hospitalized patients) study, administering a high protein oral nutritional supplement (ONS) containing beta-hydroxy-beta-methylbutyrate (HP-HMB) to hospitalised older adult patients led to a significant improvement in survival compared with a placebo treatment. The aim of this study was to determine whether HP-HMB would be cost-effective in Spain. We performed a cost-effectiveness analysis from the perspective of the Spanish National Health System using time horizons of 90 days, 180 days, 1 year, 2 years, 5 years and lifetime. The difference in cost between patients treated with HP-HMB and placebo was €332.75. With the 90 days time horizon, the difference in life years gained (LYG) between both groups was 0.0096, resulting in an incremental cost-effectiveness ratio (ICER) of €34,700.62/LYG. With time horizons of 180 days, 1 year, 2 years, 5 years and lifetime, the respective ICERs were €13,711.68, €3377.96, €2253.32, €1127.34 and €563.84/LYG. This analysis suggests that administering HP-HMB to older adult patients admitted to Spanish hospitals during hospitalisation and after discharge could be a cost-effective intervention that would improve survival with a reduced marginal cost.


NOURISH study; Spain; beta-hydroxy-beta-methylbutyrate; cost-effectiveness; malnutrition; oral nutritional supplement

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