PD263 - COST COMPARISON OF SEMI-ELEMENTAL PEPTIDE-BASED ENTERAL NUTRITION FORMULA FIRST LINE VERSUS STANDARD FORMULA IN CRITICALLY ILL ADULTS IN INTENSIVE CARE UNITS WHO ARE AT RISK OF GASTROINTESTINAL INTOLERANCE: A COHORT COST-CONSEQUENCE MODEL FOR BRAZIL.
PD263
COST COMPARISON OF SEMI-ELEMENTAL PEPTIDE-BASED ENTERAL NUTRITION FORMULA FIRST LINE VERSUS STANDARD FORMULA IN CRITICALLY ILL ADULTS IN INTENSIVE CARE UNITS WHO ARE AT RISK OF GASTROINTESTINAL INTOLERANCE: A COHORT COST-CONSEQUENCE MODEL FOR BRAZIL.
L. Dainelli1,*, V. Marzagao2, V. Rosenfeld2, C. Steeds3, H. Falcao Ramos da Cunha4,5,6
1Global Market Access & Pricing, Nestlé Nutrition & Health, Vevey, Switzerland, 2Medical & Scientific Affairs, Nestlé Nutrition & Health, Sao Paulo, Brazil, 3Carolyn Steeds Consulting, Motherwell, United Kingdom, 4CMO, Nutrotech, 5Equipe de suporte nacional, Clinica Sao Vicente da Gavea, 6Intensivist , Hospital central PMERJ, Rio de Janeiro, Brazil
Rationale: Critically ill adults often experience gastrointestinal intolerance to enteral nutrition which increases their length of stay in ICU. Semi-elemental, peptide-based formula can reduce gastrointestinal intolerance in ICU patients but are often reserved for second line use due to higher costs. We explored the ICU-related costs of using specialized formula first line versus standard formula in Brazil.
Methods: A decision-tree model was developed from the Brazilian public and private perspective. Patients in ICU with a Gastrointestinal Dysfunction Score (GIDS) >2 received specialized or standard formula, with the latter switching to specialized formula in the event of intolerance. A literature review supported the model inputs. Unit costs for Brazil were applied to enteral formula and ICU stays. A one-way sensitivity analysis was performed to assess uncertainty.
Results: There was a cost saving of R$1,798 (US$345) per patient to the public system from using specialized formula first line in ICU adults at risk of gastrointestinal intolerance compared with initiating with standard formula and switching in the event of intolerance. For private insurance, cost savings ranged from R$787 to R$1,352 per patient for specialized versus standard formula. Length of stay in ICU and cost of a day in ICU were key drivers of cost.
Conclusion: Using semi-elemental, peptide-based formula first line in critically ill ICU patients at risk of gastrointestinal intolerance (GIDS >2) may be cost savings versus initiating with standard formula and switching to specialized formula when gastrointestinal intolerance occurs. The higher cost of specialized formula was offset by reduced gastrointestinal intolerance and shorter ICU stays.
Disclosure of Interest: L. Dainelli Other: works for Nestlé, V. Marzagao Other: works for Nestlé , V. Rosenfeld Other: works for Nestlé, C. Steeds Consultant for: Nestlé, H. Falcao Ramos da Cunha Consultant for: Nestlé