ESPEN 2013 - Late breaking abstract submission

Late Breaking Abstract

ESPEN13-1844

UPDATE ON PHARMACOECONOMICS IN NUTRITION: PARENTERAL GLUTAMINE SUPPLEMENT IN INTENSIVE CARE UNIT PATIENTS

L. Pradelli ^1,*O. Zaniolo ¹M. Muscaritoli ²M. Eandi ³

¹ADRES HEALTH ECONOMICS AND OUTCOMES RESEARCH, Torino, ²Clinical Medicine, Università La Sapienza, Roma, ³Pharmacology, Università di Torino, Torino, Italy

Rationale: To re-evaluate the economic consequences of parenteral glutamine supplementation (PGS) in light of the recent meta-analysis confirming that  PGS at a dose >0,20 g/kg body weight per day in intensive care unit (ICU) patients is associated with reduced mortality, infection rate (IR) and length of stay (LOS). 

Methods: A simulation model was updated with the new meta-analysis data and clinical inputs for the control group from Italian ICU population reported in “Progetto Margherita”. Costs are evaluated from the perspective of the Italian hospital and derive from official sources. Sensitivity analyses are undertaken to test results’ reliability

Results: PGS is predicted to reduce mortality rates (-29.0%), IR (-21.2%) and overall LOS (-1.07 days/patient), yielding a saving of € 1,047 per patient treated. Treatment costs are completely offset by the reduction in hospital stay costs and antibiotic costs. Probabilistic sensitivity analysis indicates PGS strategy as dominant in more than 90% of cases.

Conclusion: Also with contemporary comparative efficacy data is PGS in ICU patients expected to be effective in improving outcomes and containing costs in Italian hospitals providing intensive care.

References: Bollhalder L et al. ” A systematic literature review and meta-analysis of randomized clinical trials of parenteral glutamine supplementation”, Clinical Nutrition 32 (2013) 213-223.

Pradelli L et al.:“ Effectiveness and cost-effectiveness of supplemental Glutamine dipeptide in total parenteral nutrition therapy for critically ill patients: a discrete event simulation model based on Italian data”, Int J Tech Ass Health Care, 28:1 (2012), 22-28.

Disclosure of Interest: L. Pradelli Grant / Research Support from: Fresenius Kabi GmbhO. Zaniolo Other: AdRes employeeM. Muscaritoli: None DeclaredM. Eandi: None Declared

Keywords: economyParenteral nutrition therapy