Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing

E. Cereda, C. Klersy, M. Andreola, R. Pisati, J.M.G.A. Schols, R. Caccialanza, F. D'Andrea, the OligoElement Sore Trial (OEST) Study Group

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Background & aims The Oligo Element Sore Trial has shown that supplementation with a disease-specific nutritional formula enriched with arginine, zinc, and antioxidants improves pressure ulcer (PU) healing in malnourished patients compared to an isocaloric–isonitrogenous support. However, the use of such a nutritional formula needs to be supported also by a cost-effectiveness evaluation. Methods This economic evaluation – from a local healthcare system perspective – was conducted alongside a multicenter, randomized, controlled trial following a piggy-back approach. The primary efficacy endpoint was the percentage of change in PU area at 8 weeks. The cost analysis focused on: the difference in direct medical costs of local PU care between groups and incremental cost-effectiveness ratio (ICER) of nutritional therapy related to significant study endpoints (percentage of change in PU area and ≥40% reduction in PU area at 8 weeks). Results Although the experimental formula was more expensive (mean difference: 39.4 Euros; P < 0.001), its use resulted in money saving with respect to both non-nutritional PU care activities (difference, −113.7 Euros; P = 0.001) and costs of local PU care (difference, −74.3 Euros; P = 0.013). Therefore, given its efficacy it proved to be a cost-effective intervention. The robustness of these results was confirmed by the sensitivity analyses. Conclusion The use of a disease-specific oral nutritional formula not only results in better healing of PUs, but also reduces the costs of local PU care from a local healthcare system perspective
Original languageEnglish
Pages (from-to)246-252
Number of pages7
JournalClinical Nutrition
Issue number1
Early online date2 Dec 2015
Publication statusPublished - 1 Feb 2017


  • Pressure ulcers
  • Oral nutritional support
  • Healing
  • Cost-effectiveness
  • Incremental cost-effectiveness ratio

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