Details

Autor(en) / Beteiligte

• Freijer, K

Titel

Nutrition Economics and the Economic Value of the Dietitian

Ist Teil von

• Annals of nutrition and metabolism, 2018-02, Vol.72 (1), p.71

Ort / Verlag

Basel: S. Karger AG

Erscheinungsjahr

2018

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Introduction: For pharmaceuticals and other health technologies including devices, it is common practice since several years to show their added value using health economics data such as in supporting the application for reimbursement. Time has now come for dietitians/nutritionists to demonstrate their added value within a complete patient treatment plan, in order to be a serious player in the era of competitive funding in health care, not just at the macro level (government), but also at the meso (institutions) and micro (patient) levels. Given the increasing pressure on policy makers and health care providers to obtain as much health benefit as possible within a limited budget, cost-effectiveness analyses are increasingly important. Although the general methods for per- forming health economic evaluations can also be applied to (medical) nutrition, experts concluded that specific characteristics of nutrition need special attention. Therefore, a new area within the field of "health economics" has been developed, called "Nutrition Economics" (NE). Results/Discussion: Already for years it has been shown that optimal nutrition as part of the total lifestyle has numerous benefits, such as decreasing the development of non-communicable diseases (e.g., obesity, diabetes, cardiovascular diseases) together with all its negative consequences. Also, as part of the total patient treatment, optimal nutrition including medical nutrition has resulted in an increase of nutritional, functional, and clinical benefits as shown in numerous evidence-based publications. Recognizing the need to show the added value of nutrition from an economic perspective, nutrition economic evaluations can help answering the question about how limited health care resources could be allocated when facing unlimited wants in order to achieve the maximum health benefit. Such evaluations assess alternative courses of action in terms of both their costs and consequences and are called cost-benefit, cost-effectiveness, cost-utility, or cost minimization analysis depending on the chosen measures of the consequences, that is, monetary, natural units, or preference-based measures. The analysis typically looks at the extra costs needed to achieve 1 extra unit of clinical outcome expressed as a ratio between the two. The cost-effectiveness ratio of a certain program can then be compared with the ratio found in other programs. This will show whether or not the program is achieving the maximum incremental (marginal) health benefit for a fixed amount of resources (costs). Few published nutrition economic evaluations demonstrated that spending money on optimal nutrition management of, for instance, malnourished patients including the use of medical nutrition is cost-effective and mostly even cost-saving. For each euro that is invested in this management, society saves around €z2 to €z4. Other reports have calculated that investing in dietetics is "gaining" money, as only they are the qualified specialists on nutrition knowing when and which nutrition intervention(s) should be used in accordance with the latest scientific evidence. The dietetic treatment of patients with obesity and obesity-related diseases creates social benefits of ...0.4 to €z1.9 billion over a period of 5 years. For every euro spent on dietetics for malnourished patients, the benefit to society is €z3.08-22.60 euros (gastrointestinal or lung cancer), €z2.40-4.50 euros (head and neck cancer), and €z1.20-1.90 euros (malnourished elderly hospital patients). Investing on getting the right nutrition to the right person at the right time instead of economizing on optimal nutrition should thus be the standard. To elaborate on developing a systematic approach or specific methodology in the field of nutrition outcomes research to assess the clinical, economic, and quality of life outcomes on patient health for both researchers and health care decision makers as well as in preventive nutrition interventions and daily food habits as part of lifestyle in the general (at risk) population, thus covering the total nutrition economics field, 2 officially acknowledged international special interest groups for Nutrition Economics were founded in 2014: the ISPOR Special Interest Group (SIG) Nutrition Economics (https://www.ispor.org/sigs/NutritionEconomics. aspx) and HTAi Interest Group InPHORM (https://www.htai.org/ interest-groups/inphorm/) Conclusion: Nutrition economics is a newly developed area within the field of "health economics" and can be used to show the added value of nutrition. As the specialist in nutrition, only the dietitian is able to provide the optimal nutrition management needed according to the current scientific evidence, which has shown to be a cost-effective and mostly cost saving investment.