Decision tree model for early use of semi-elemental formula versus standard polymeric formula in critically ill Malaysian patients: A cost-effectiveness study

Adam, Aisha and Ibrahim, Noor Airini and Tah, Pei Chien and Liu, Xin Yi and Dainelli, Livia and Foo, Chee Yoong (2023) Decision tree model for early use of semi-elemental formula versus standard polymeric formula in critically ill Malaysian patients: A cost-effectiveness study. Journal of Parenteral And Enteral Nutrition, 47 (8). pp. 1003-1010. ISSN 0148-6071, DOI https://doi.org/10.1002/jpen.2554.

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Abstract

BackgroundPrevention of enteral feeding interruption (EFI) improves clinical outcomes of critically ill intensive care unit (ICU) patients. This leads to shorter ICU stays and thereby lowers healthcare costs. This study compared the cost of early use of semi-elemental formula (SEF) in ICU vs standard polymeric formula (SPF) under the Ministry of Health (MOH) system in Malaysia. MethodsA decision tree model was developed based on literature and expert inputs. An epidemiological projection model was then added to the decision tree to calculate the target population size. The budget impact of adapting the different enteral nutrition (EN) formulas was calculated by multiplying the population size with the costs of the formula and ICU length of stay (LOS). A one-way sensitivity analysis (OWSA) was conducted to examine the effect each input parameter has on the calculated output. ResultsReplacing SPF with SEF would lower ICU cost by MYR 1059 (USD 216) per patient. The additional cost of increased LOS due to EFI was MYR 5460 (USD 1114) per patient. If the MOH replaces SPF with SEF for ICU patients with high EFI risk (estimated 7981 patients in 2022), an annual net cost reduction of MYR 8.4 million (USD 1.7 million) could potentially be realized in the MOH system. The cost-reduction finding of replacing SPF with SEF remained unchanged despite the input uncertainties assessed via OWSA. ConclusionEarly use of SEF in ICU patients with high EFI risk could potentially lower the cost of ICU care for the MOH system in Malaysia.

Item Type: Article
Funders: Nestle Health Science
Uncontrolled Keywords: Costs; Enteral feeding interruption; Enteral nutrition; Intensive care unit; Semi-elemental formula
Subjects: R Medicine
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 30 Oct 2025 06:49
Last Modified: 30 Oct 2025 06:49
URI: http://eprints.um.edu.my/id/eprint/48660

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