Cost analysis of neonatal and pediatric parenteral nutrition in Europe: a multi-country study

OBJECTIVES: Parenteral nutrition (PN) is critical in neonatal and pediatric care for patients unable to tolerate enteral feeding. This study assessed the total costs of compounding PN therapy for neonates, infants and children. METHODS: Face-to-face and telephone interviews were conducted in 12 hospitals across four European countries (Belgium, France, Germany and UK) to collect information on resources utilized to compound PN, including nutrients, staff time, equipment cost and supplies. A bottom-up cost model was constructed to assess total costs of PN therapy by assigning monetary values to the resource utilization using published list prices and interview data. RESULTS: A total of 49 922 PN bags per year were used to treat 4295 neonatal and pediatric patients among these hospitals. The daily total costs of one compounded PN bag for neonates in the 12 hospitals across the four countries equalled (sic)55.16 (Belgium (sic)53.26, France (sic)46.23, Germany (sic)64.05, UK (L) over bar 37.43/(sic)42.86). Overall, nutrients accounted for 25% of total costs, supplies 18%, wages 54% and equipment 3%. Average costs per bag for infants <2 year were (sic)84.52 ((sic)74.65 in Belgium, (sic)83.84 in France, (sic)92.70 in Germany and <(L)over bar>52.63/(sic)60.26 in the UK), and for children 2-18 years (sic)118.02 ((sic)93.85 in Belgium, (sic)121.35 in France, (sic)124.54 in Germany and (L) over bar 69.49/(sic)79.56 in the UK), of which 63% is attributable to nutrients and 28% to wages. CONCLUSION: The data indicated that PN costs differ among countries and a major proportion was due to staff time ((L) over bar1 = (sic)1.144959).