Economics of total parenteral nutrition.

Better data on the effectiveness of TPN are required, along with good costing data on the procedure and its benefits. The Veterans Administration Cooperative Trial on Perioperative TPN will be collecting such data. In this randomized trial, data are being collected on both the effectiveness of the procedure and the costs, direct and indirect, of the procedure and its consequences. Similar studies for other indications will help to establish fully the economics of TPN. As Steinberg and Anderson point out, it is important to remember that the absence of evidence that a procedure is not cost-effective does not imply that it is not cost-effective. As this review has shown, the cost-effectiveness of TPN has been evaluated for only a few indications. The results of more extensive cost-effectiveness analyses remain to be seen.