Cost and effectiveness of omega-3 fatty acid supplementation in Chinese ICU patients receiving parenteral nutrition
Authors Wu GH, Gao J, Ji CY, Pradelli L, Xi QL, Zhuang QL
Received 21 January 2015
Accepted for publication 6 May 2015
Published 26 June 2015 Volume 2015:7 Pages 369—375
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Giorgio Lorenzo Colombo
Guo Hao Wu,1 Jian Gao,2 Chun Yan Ji,2 Lorenzo Pradelli,3 Qiu Lei Xi,1 Qiu Lin Zhuang1
1Department of General Surgery, 2Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China; 3AdRes Health Economics and Outcomes Research, Piazza Carlo Emanuele II, Torino, Italy
Background and objectives: Clinical evidence supports the use of omega-3 polyunsaturated fatty acid (PUFA)-enriched lipid emulsions in place of standard lipid emulsions in parenteral nutrition (PN) for intensive care unit (ICU) patients, but uptake may be limited by higher costs. We compared clinical and economic outcomes for these two types of lipid emulsion in the Chinese ICU setting.
Methods: We developed a pharmacoeconomic discrete event simulation model, based on efficacy data from an international meta-analysis and patient characteristics, resource consumption, and unit costs from a Chinese institutional setting. Probabilistic sensitivity analyses were undertaken to assess the effects of uncertainty around input parameters. Model predictive validity was assessed by comparing results with data observed in a patient subset not used in the modeling.
Results: The model predicted that omega-3 PUFA-enriched emulsion (Omegaven® 10% fish oil emulsion) would dominate standard lipid emulsions, with better clinical outcomes and lower overall health care costs (mean savings ~10,000 RMB), mainly as a result of faster recovery and shorter hospital stay (by ~6.5 days). The external validation process confirmed the reliability of the model predictions.
Conclusion: Omega-3 PUFA-enriched lipid emulsions improved clinical outcome and decreased overall costs in Chinese ICU patients requiring PN.
Keywords: omega-3 PUFA-enriched lipids, ICU patients, total costs, microsimulation, external validation, length of hospital stay
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