Aktuelle Ernährungsmedizin 2012; 37(03): 126-133
DOI: 10.1055/s-0032-1304940
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

The Health Economic Impact of Oral Nutritional Supplements (ONS) in Germany

Gesundheitsökonomische Analyse der medizinischen Trinknahrungen in Deutschland
M. Nuijten
1   Ars Accessus Medica, Amsterdam, The Netherlands
,
T. Mittendorf
2   Herescon GmbH, Hannover, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
01 June 2012 (online)

Abstract

Purpose: To assess the health economic impact of oral nutritional supplement (ONS), being a medical nutrition product in the community setting in Germany in 2007.

Methods: This health economic analysis is based on a comparison of the use of ONS versus no use of ONS in patients, who are eligible for ONS due to (risk of) disease-related malnutrition (DRM). The costs of the two treatment strategies, “ONS” versus “no ONS” were assessed using a linear decision analytic model reflecting cost functions related with DRM. Data sources are based on the published literature, clinical trials, official national price/tariff lists and national population statistics.

Results: This study shows that the extra costs for ONS (€ 534) are off-set by a reduction of hospitalisation costs (€ 768) leading to total cost savings of € 234 per patient. A scenario analysis based on length of hospital stays and per diem costing instead of DRG costs shows that the extra costs for ONS (€ 534) are also off-set by a reduction of hospitalisation costs (€ 791) leading to cost savings of € 257 per patient. Additional scenarios showed similar and consistent results.

Conclusions: This health economic analysis shows that the use of ONS leads to cost savings for the cost of DRM in Germany in the community setting. In addition the use of ONS leads also to better clinical outcomes due to a reduction of hospitalisations. As a consequence the use of ONS might be considered cost-effective at a patient and also a population level, which could be shown also in extensive sensitivity analyses.

Zusammenfassung

Hintergrund: Durchführung einer gesundheitsökonomischen Analyse zur medizinischen Trinknahrung im Behandlungsalltag in Deutschland für 2007.

Methoden: Diese gesundheitsökonomische Analyse basiert auf dem Vergleich einer Intervention mit Trinknahrung vs. ohne diese Ergänzung bei Patienten, die aufgrund von krankheitsbedingten Risikofaktoren ein erhöhtes Risiko aufweisen, eine Mangelernährung auszubilden oder bereits eine ausgebildet haben. Die Kosten beider Strategien werden mittels eines linearen Entscheidungsmodells miteinander verglichen. Datenquellen sind dabei Erkenntnisse der bestehenden Literatur, klinische Studien, offizielle Statistiken sowie offizielle Preistabellen für die Abrechnung innerhalb der Sozialversicherung.

Ergebnis: Die Studie zeigt, dass die zusätzlichen Kosten für die Nahrungsergänzung (€ 534) von Einsparungen im Krankenhaus (€ 768) mehr als aufgewogen werden und zu Einsparungen von durchschnittlich € 234 pro Patient führen. Eine Szenarioanalyse, die anstatt DRG Tagesvergütungen für Krankenhäuser einsetzt, führt zu einem ähnlichen Ergebnis mit Einsparungen von € 257 pro Patient. Weitere Szenarien führten zu ebenfalls konsistenten Ergebnissen.

Zusammenfassung: Diese gesundheitsökonomische Studie hat gezeigt, dass der Einsatz von Trinknahrungsinterventionen zu Kosteneinsparungen innerhalb des Behandlungsalltags in Deutschland führen kann. Zusätzlich sind durch den Einsatz positive Effekte auf den klinischen Zustand einzelner Patienten sowie eine Reduzierung von Krankenhausaufenthalten zu erwarten. Somit kann die Gabe von Trinknahrungsmitteln auf Patienten- als auch auf Populationsebene als kosteneffektive Intervention betrachtet werden.

 
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