Cost analysis of parenteral nutrition regimens in the intensive care unit: three-compartment bag system vs multibottle system.

BACKGROUND

Parenteral nutrition (PN) can be administered with separate bottles or as commercially prepared all-in-one systems. The aim of this study was to evaluate the overall cost of PN using the 3-compartment bag vs standard multibottle system.

METHODS

Overall costs of hospital PN were calculated from expenditures (solutions, consumable items, and staff costs). Time that staff spent preparing the PN was measured to determine personnel costs; bottom-up costing was used to assign a monetary value. Standard treatment algorithms of a 10-day course of PN for a standard 70-kg patient were specified for both systems. One-way sensitivity analyses were performed to test the robustness of the model's conclusions.

RESULTS

The daily total cost of the 3-compartment bag system was euro42.26 per patient whereas the total cost of the separate bottle system was euro51.62, resulting in a cost saving of euro9.36 per patient with the 3-compartment bag system. For 10 days of treatment, PN costs euro422.51 per patient for the 3-compartment system vs euro516.16 for the multibottle system. Sensitivity analyses showed that the difference in costs between the 2 systems was maintained in the face of changes in patients' nutrition requirements and personnel costs.

CONCLUSIONS

The costs associated with PN using a 3-compartment bag system were lower than those associated with a multibottle system. Given the established therapeutic equivalence of the 2 systems, this study shows the 3-compartment bag system to be the system of choice to reduce costs.