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Research Article: Budget impact analysis of energy and nutrient-dense oral nutritional formulas for hospitalized pediatric disease-related malnutrition in the Middle East

Date Published: 2026-06-15

Abstract:
Disease-related malnutrition is a significant yet underappreciated burden among hospitalized children, particularly in the Middle East, where data on prevalence and economic effects are few. DRM perpetuates a vicious cycle in which diseases lead to malnutrition, and malnutrition in turn worsens disease outcomes, prolongs recovery, and raises healthcare expenses. Although nutritional treatments are clinically useful in DRM management, information on their economic effects is sparse. To estimate the budget impact and potential cost savings of introducing energy-and nutrient-dense formulas (ENDFs) for hospitalized pediatric DRM patients aged 0–5?years across public and private sectors in Egypt, Saudi Arabia, Kuwait, and the United Arab Emirates. An Excel-based cost calculator model compared standard nutritional formulas to ENDFs over a one-year horizon from a healthcare payer’s perspective across both public and private sectors. The model estimated annual direct medical costs, incorporating population inputs, formulas, and hospitalization costs, as well as hospital length of stay (LOS), informed by expert consultations. One-way sensitivity analyses (±20%) were conducted to assess the model’s robustness. Further, Scenario analyses using alternative uptake assumptions (25, 50, and 75%) were also conducted to improve the practical relevance of the model. The use of ENDFs was linked to consistent reductions in LOS (19–50%) and significant cost savings (15–50%), mainly driven by lower hospitalization expenses, which made up over 95% of total costs. Sensitivity analysis showed that prevalence, LOS reduction percentage, and baseline LOS were the main cost drivers, in line with previous economic models. The findings demonstrate the clinical and economic value of ENDFs in managing pediatric DRM, through reduced hospital length of stay and associated costs, supporting their broader adoption.

Introduction:
Disease-related malnutrition is a significant yet underappreciated burden among hospitalized children, particularly in the Middle East, where data on prevalence and economic effects are few. DRM perpetuates a vicious cycle in which diseases lead to malnutrition, and malnutrition in turn worsens disease outcomes, prolongs recovery, and raises healthcare expenses. Although nutritional treatments are clinically useful in DRM management, information on their economic effects is sparse.

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