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ω-3 脂肪酸肠外营养在 5 个欧洲国家和美国住院成年患者中的成本效益

Cost-Effectiveness of Parenteral Nutrition Containing ω-3 Fatty Acids in Hospitalized Adult Patients From 5 European Countries and the US.

机构信息

AdRes-Health Economics and Outcome Research, Turin, Italy.

Department of General and Oncology Surgery with Intestinal Failure Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland.

出版信息

JPEN J Parenter Enteral Nutr. 2021 Jul;45(5):999-1008. doi: 10.1002/jpen.1972. Epub 2020 Aug 18.

Abstract

BACKGROUND

ω-3 Fatty acid (FA)-containing parenteral nutrition (PN) is associated with improvements in patient outcomes and with reductions in hospital length of stay (HLOS) vs standard PN regimens (containing non-ω-3 FA lipid emulsions). We present a cost-effectiveness analysis of ω-3 FA-containing PN vs standard PN in 5 European countries (France, Germany, Italy, Spain, UK) and the US.

METHODS

This pharmacoeconomic model was based on estimates of ω-3 efficacy reported in a recent meta-analysis and data from country-specific sources. It utilized a probabilistic discrete event simulation model to compare ω-3 FA-containing PN with standard PN in a population of critically ill and general ward patients. The influence of model parameters was evaluated using probabilistic and deterministic sensitivity analyses.

RESULTS

Overall costs were reduced with ω-3 FA-containing PN in all 6 countries compared with standard PN, ranging from €1741 (±€1284) in Italy to €5576 (±€4193) in the US. Expenses for infections and HLOS were lower in all countries for ω-3 FA-containing PN vs standard PN, with the largest cost differences for both in the US (infection: €825 ± €4001; HLOS: €4879 ± €1208) and the smallest savings in the UK for infections and in Spain for HLOS (€63 ± €426 and €1636 ± €372, respectively).

CONCLUSION

This cost-effectiveness analysis in 6 countries demonstrates that the superior clinical efficacy of ω-3 FA-containing PN translates into significant decreases in mean treatment cost, rendering it an attractive cost-saving alternative to standard PN across different healthcare systems.

摘要

背景

与标准肠外营养(PN)方案(含非ω-3 脂肪酸脂乳剂)相比,含ω-3 脂肪酸的 PN 与患者转归的改善和住院时间(HLOS)的减少有关。我们在 5 个欧洲国家(法国、德国、意大利、西班牙和英国)和美国进行了含ω-3 脂肪酸的 PN 与标准 PN 的成本效益分析。

方法

该药物经济学模型基于最近的一项荟萃分析中报告的ω-3 疗效估计值和来自特定国家来源的数据。它使用概率离散事件模拟模型来比较危重患者和普通病房患者群体中含ω-3 脂肪酸的 PN 与标准 PN。使用概率和确定性敏感性分析评估模型参数的影响。

结果

与标准 PN 相比,在所有 6 个国家中,含ω-3 脂肪酸的 PN 均可降低总体成本,从意大利的€1741(±€1284)到美国的€5576(±€4193)。与标准 PN 相比,含ω-3 脂肪酸的 PN 在所有国家的感染和 HLOS 费用均较低,美国的成本差异最大(感染:€825(±€4001);HLOS:€4879(±€1208)),而英国的感染费用和西班牙的 HLOS 费用节省最小(分别为€63(±€426)和€1636(±€372))。

结论

这项在 6 个国家进行的成本效益分析表明,含ω-3 脂肪酸的 PN 的优越临床疗效转化为治疗成本的显著降低,使其成为不同医疗保健系统中具有吸引力的节省成本的替代方案。

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