New research suggests specialized nutrition cost-effectively extends lives of malnourished hospitalized adults
ABBOTT PARK, Ill. Aug. 30, 2016-As a majority of older adults have two or more chronic conditions,2 finding new ways to improve their health and decrease the cost of care is vital to helping them live healthier, longer lives. A new study found that malnourished older adults who were hospitalized with a heart or lung disease had an additional 8.5 months of estimated life expectancy when they received a specialized nutrition supplement, compared to a placebo group.1 The study, published online in Applied Health Economics and Health Policy and supported by Abbott, shows that nutrition can be a cost-effective treatment ($524 for each year saved) to address malnutrition associated with these diseases.
"By the year 2023, the number of chronic disease cases are expected to grow 42 percent, which experts believe could cause an additional $4.2 trillion in treatment costs and lost economic output," said Scott Goates, PhD, health economist at Abbott and one of the study co-authors. "Proper nutrition is proven to help people achieve better health and improve quality of life, especially when managing a disease. Our analysis confirms nutrition is a highly cost-effective way to extend lives, having an impact well beyond their initial recovery."
The study was an analysis of NOURISH, a first-of-its-kind clinical nutrition study that showed the same group of older malnourished adults who took a specialized nutrition supplement (Ensure® Enlive®) had a 50 percent lower death rate 90 days after hospitalization.3 This analysis was designed to assess the economic impact of nutrition by examining the total healthcare costs; a person's estimated life years gained; and their estimated quality adjusted life years (QALYs), a metric that health economists use to determine a person's estimated life expectancy and their quality of life. For example, one year in perfect health equals one QALY.
When evaluating the cost-effectiveness of the treatment in the 90-day study period, researchers found that those who received a specialized nutrition supplement had these improved health outcomes for less than $34,000 per QALY, which is well below the typical benchmark of $50,000 to $100,000. When those benefits are projected over the lifetime of an estimated 8.77 years compared to the placebo group of 8.06 years, the therapy would cost only $524 for each year of life saved. Study authors noted that the cost-effectiveness of the supplement is on par with other renowned preventive treatments, such as aspirin, flu vaccines and warfarin when used for at-risk populations.1
Both the NOURISH study and health economic analysis add to the growing body of evidence that show unequivocally the power of nutrition in impacting people's overall health and nutrition status, ranging from rebuilding muscle mass to helping with recovery from disease and time in the hospital.
"The results of our study suggest an opportunity to improve the health and survival of these patients at a low marginal cost. Few interventions that have been studied have shown health gains less expensively, particularly in this population," said Josh Cohen, deputy director, Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and one of the study co-authors. "As payers shift towards value-based purchasing, healthcare professionals and providers may be encouraged to further examine interventions that deliver cost-effective results."
About the Study:
The Cost-Effectiveness of Oral Nutrition Supplementation for Malnourished Older Hospital Patients was an economic analysis of the NOURISH study, a multicenter, randomized, controlled clinical trial. Researchers looked at malnourished people aged 65+ who were hospitalized with a heart or lung disease. Over a 90-day period, researchers compared a specialized nutrition supplement containing high protein and β-hydroxy-β-methylbutyrate (HMB) to a placebo, and projected those findings to look at their estimated life expectancy. Outcomes included healthcare costs, measured as the product of resource use and per unit cost; quality-adjusted life years (QALYs) (90-day time horizon); life-years (LYs) saved (lifetime time horizon); and the incremental cost-effectiveness ratio (ICER). All costs were inflated to 2015 U.S. dollars.
The analysis was based on the results from the NOURISH clinical study, which found that the same specialized nutrition supplement was associated with improved nutritional status, body weight and mortality rate in older malnourished adults in the hospital with a heart or lung condition. Results showed no significant differences between the treatment and placebo groups for the primary composite (i.e., combined) endpoint of hospital readmissions or death, but individual study components showed a significantly lower (50 percent) death rate for those patients who received the specialized nutrition supplement.
The specialized nutrition supplement used in the NOURISH study is available in hospitals and retail stores as Ensure® Enlive®.
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1. Zhong Y et al. Applied Health Economics and Health Policy. 2016; published online 8 August 2016. http://link.springer.com/article/10.1007/s40258-016-0269-7
2. National Council on Aging, "Healthy Aging Facts."
3. Deutz N et al. Clin. Nutr. 2016; published online 18 January 2016. http://dx.doi.org/10.1016/j.clnu.2015.12.010