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Clinical nutrition, enteral and parenteral nutrition

Cost analysis of neonatal and pediatric parenteral nutrition in Europe: a multi-country study

European Journal of Clinical Nutrition volume 66, pages 639–644 (2012)Cite this article

Subjects

Abstract

OBJECTIVES:

Parenteral nutrition (PN) is critical in neonatal and pediatric care for patients unable to tolerate enteral feeding. This study assessed the total costs of compounding PN therapy for neonates, infants and children.

METHODS:

Face-to-face and telephone interviews were conducted in 12 hospitals across four European countries (Belgium, France, Germany and UK) to collect information on resources utilized to compound PN, including nutrients, staff time, equipment cost and supplies. A bottom-up cost model was constructed to assess total costs of PN therapy by assigning monetary values to the resource utilization using published list prices and interview data.

RESULTS:

A total of 49 922 PN bags per year were used to treat 4295 neonatal and pediatric patients among these hospitals. The daily total costs of one compounded PN bag for neonates in the 12 hospitals across the four countries equalled €55.16 (Belgium €53.26, France €46.23, Germany €64.05, UK Ł37.43/€42.86). Overall, nutrients accounted for 25% of total costs, supplies 18%, wages 54% and equipment 3%. Average costs per bag for infants <2 year were €84.52 (€74.65 in Belgium, €83.84 in France, €92.70 in Germany and Ł52.63/€60.26 in the UK), and for children 2–18 years €118.02 (€93.85 in Belgium, €121.35 in France, €124.54 in Germany and Ł69.49/€79.56 in the UK), of which 63% is attributable to nutrients and 28% to wages.

CONCLUSION:

The data indicated that PN costs differ among countries and a major proportion was due to staff time (Ł1=€1.144959).

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Acknowledgements

Institute for Pharmaeconomic Research (IPF), Vienna, Austria received funding from Baxter Healthcare Corporation, Deerfield, IL, USA and Baxter Healthcare SA, Switzerland for conducting the study. We would like to thank Robin Turpin, PhD for her comments.

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Authors and Affiliations

  1. Institute for Pharmacoeconomic Research, Vienna, Austria

    E Walter & A Dragosits

  2. Baxter Healthcare Corporation, Deerfield, IL, USA

    F X Liu

  3. Clinique St. Vincent, Rocourt, Belgium

    P Maton

  4. APHP′ Hôpital Robert Debré, Service Pharmacie, Paris, France

    T Storme & M Perrinet

  5. Marien-Hospital Witten, Witten, Germany

    O von Delft

  6. Leeds General Infirmary, Leeds, UK

    J Puntis & D Hartigan

  7. Baxter Healthcare SA, Zürich, Switzerland

    S Sondhi

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  1. E Walter
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Correspondence to E Walter.

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Competing interests

Evelyn Walter and Aline Dragosits are employees of IPF, Frank Xiaoqing Liu is employee of Baxter Healthcare Corporation, Seema Sondhi is employee of Baxter Healthcare SA. The remaining authors declare no conflict of interest.

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Walter, E., Liu, F., Maton, P. et al. Cost analysis of neonatal and pediatric parenteral nutrition in Europe: a multi-country study. Eur J Clin Nutr 66, 639–644 (2012). https://doi.org/10.1038/ejcn.2011.225

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