Abstract
BackgroundDysphagia is a well-known stroke complication characterised by difficulty in swallowing. It may affect the majority of stroke patients and increases mortality and morbidity, due to aspiration pneumonia and malnutrition. Food thickening may help patients to feed themselves, and its effectiveness was demonstrated. However, the cost-effectiveness studies are lacking. We evaluate the cost-utility of xanthan gum-based consistency modification therapy (Nutilis Clear®) in adult post-stroke patients from the public payer perspective in Poland.MethodsRoutine clinical practice was used as a comparator, as no alternative specific treatment for dysphagia is available. To verify the robustness of the results against the modelling approach, we built two models: a static (a fixed simple-equations model, 8-week time horizon of dysphagia) and a dynamic one (Markov model, with a possible dysphagia resolution over a 1-year horizon). In both models, the treatment costs, health state utilities, and clinical events (i.e. aspiration, aspiration pneumonia, death) were included. Parameters were estimated jointly for both models, except for the duration of dysphagia and the risk of aspiration pneumonia (specific to the time horizon). We only assumed Nutilis Clear® to prevent aspirations, without affecting dysphagia duration.ResultsThe average cost of one quality-adjusted life year (i.e. the incremental cost-utility ratios, ICURs) amounted to 21,387 PLN (€1 ≈ 4.5 PLN), and 20,977 PLN in static and dynamic model, respectively; far below the cost-effectiveness threshold in Poland (147,024 PLN). The one-way, scenario, and probabilistic sensitivity analysis confirmed these findings.ConclusionsNutilis Clear® is highly cost-effective in Poland from the public payer perspective. Our approach can be used in other countries to study the cost-effectiveness of food thickening in stroke patients.
Highlights
Dysphagia is a well-known stroke complication characterised by difficulty in swallowing
We evaluate the cost-utility of xanthan gum-based consistency modification therapy (Nutilis Clear®) in adult stroke patients with dysphagia from the public payer perspective in Poland
Incremental cost-utility ratio (ICUR) amounted to 21,387 Polish Zloty (PLN) and 20,977 PLN in static and dynamic model, respectively
Summary
Dysphagia is a well-known stroke complication characterised by difficulty in swallowing It may affect the majority of stroke patients and increases mortality and morbidity, due to aspiration pneumonia and malnutrition. We evaluate the cost-utility of xanthan gum-based consistency modification therapy (Nutilis Clear®) in adult post-stroke patients from the public payer perspective in Poland. Dysphagia may be associated with increased mortality and morbidity due to aspiration pneumonia and malnutrition [2,3,4,5,6] as well as decreased quality of life [7,8,9] It is rarely an isolated health problem, and despite many advances in healthcare post-stroke dysphagia remains unappreciated [10]. At the same time, such an evaluation could inform about the clinical and economic consequences of financing the food modification from public money and result in optimizing the care for post-stroke patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
