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Cost Analysis of Parenteral Nutrition Regimens in the Intensive Care Unit: Three-Compartment Bag System vs Multibottle System

From ¹ the Department of Anaesthesiology and Intensive Care Medicine, Marien-Hospital Witten, Germany;² the Department of Surgery, Marien-Hospital Witten, Germany; ³ HealthEcon AG, Basle, Switzerland; and⁴ the Department of Anaesthesiology and Intensive Care Medicine, University Hospital Tübingen, Germany.

Address correspondence to: Metin Senkal, MD, Department of Surgery, Marien-Hospital Witten, Marienplatz 2, 58452 Witten, Germany; e-mail: Senkal{at}Marien-Hospital-Witten.de.

Background: Parenteral nutrition (PN) can be administered with separate bottles or as commercially prepared all-in-one systems. The aim of this study was to evaluate the overall cost of PN using the 3-compartment bag vs standard multibottle system. Methods: Overall costs of hospital PN were calculated from expenditures (solutions, consumable items, and staff costs). Time that staff spent preparing the PN was measured to determine personnel costs; bottom-up costing was used to assign a monetary value. Standard treatment algorithms of a 10-day course of PN for a standard 70-kg patient were specified for both systems. One-way sensitivity analyses were performed to test the robustness of the model's conclusions. Results: The daily total cost of the 3-compartment bag system was 42.26 per patient whereas the total cost of the separate bottle system was 51.62, resulting in a cost saving of 9.36 per patient with the 3-compartment bag system. For 10 days of treatment, PN costs 422.51 per patient for the 3-compartment system vs 516.16 for the multibottle system. Sensitivity analyses showed that the difference in costs between the 2 systems was maintained in the face of changes in patients' nutrition requirements and personnel costs. Conclusions: The costs associated with PN using a 3-compartment bag system were lower than those associated with a multibottle system. Given the established therapeutic equivalence of the 2 systems, this study shows the 3-compartment bag system to be the system of choice to reduce costs.

Key Words: economic evaluation • cost comparison • parenteral nutrition (PN) • 3-compartment bag system • multibottle system

Journal of Parenteral and Enteral Nutrition, Vol. 32, No. 6, 606-612 (2008)
DOI: 10.1177/0148607108322404


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