Cost analysis of chronic intestinal failure

Area of Science:

• Gastroenterology
• Health Economics

Background:

• Chronic intestinal failure (IF) necessitates long-term home parenteral nutrition (HPN), incurring substantial costs.
• Costs are amplified by frequent hospital admissions related to the underlying disease and HPN complications.
• Specific cost breakdowns and their evolution over time in stable HPN patients remain unclear.

Purpose of the Study:

• To evaluate the cost dynamics of home parenteral nutrition (HPN) care.
• To analyze cost subdivisions in a cohort of stable, long-term intestinal failure patients.

Main Methods:

• Retrospective analysis of a single-center, long-term (>2 years) benign HPN population.
• Collection of clinical and financial data: hospital admissions, diagnostics, treatments, outpatient care, home care, medications, materials, and HPN education.
• Cost tabulation by cause: HPN-related, underlying disease-related, and disease-unrelated.

Main Results:

• Total first-year HPN cost averaged €83,503, with HPN-related expenses comprising 69%.
• HPN complications represented 31% of first-year HPN costs (€16,077).
• Annual costs decreased by 15% in year 2 and 40% by year 5 compared to year 1, attributed to reduced hospital admissions and fewer HPN complications.

Conclusions:

• HPN-related costs dominate total expenses in intestinal failure patients.
• Costs significantly decline after the initial year, driven by improved management and reduced complications.
• This study highlights the potential for cost savings through effective HPN management and complication reduction.