Reductions in Gastrointestinal Intolerance, Healthcare Resource Utilization and Cost Associated with a Plant-Based Peptide Enteral Formula with Fruit and Vegetable Ingredients: Retrospective Analysis of Children and Adults in Post-Acute Care

Gerard Minor,1 Pamela Cekola,2 Amarsinh Desai,3 Pradeep Kumar,4 Sayan Mondal,4 Yashashree Vijay Kadam,4 Katherine Fazioli,4 Abby Klosterbuer2 1Pediatric Gastroenterology Hepatology and Nutrition, KIDZ Medical Services, Hollywood, FL, USA; 2Medical Affairs, Nestlé Health Science, Bridgewater, NJ, USA; 3Market Access, Nestlé Health Science, Bridgewater, NJ, USA; 4Life Sciences & Healthcare, Clarivate Analytics, Toronto, ON, CanadaCorrespondence: Pamela Cekola, Nestlé Health Science, 1007 US Highway 202/206, Bridgewater, NJ, 08807, USA, Email [email protected]: Peptide-based enteral nutrition (EN) formulas are an alternative to standard EN formulas for patients with gastrointestinal (GI) intolerance. Evidence supports GI tolerance benefits of either peptide-based EN or EN containing fruits and vegetables. However, there is a lack of research on plant-based peptide EN with added fruit and vegetable ingredients.Patients and Methods: This retrospective study analyzed United States (US) claims data on children (1– 13 years) and adults (≥ 14 years) receiving plant-based peptide formulas with fruit and vegetable ingredients in post-acute care. Demographics, GI tolerance, healthcare resource utilization (HCRU) and costs were captured. Clinical and health economic outcomes were compared 6 months pre-index and 1-, 3- and 6-months post-index in both cohorts.Results: In total, data from 91 children and 82 adults were analyzed. Mean (standard deviation [SD]) age was 5.5 (3.0) years in children and 49.0 (20.5) years in adults. Significantly fewer children and adults experienced any GI intolerance symptoms at all post-index time points compared with pre-index (p< 0.001). Significant reductions in individual GI symptoms including constipation, diarrhea, nausea and vomiting were observed in children and adults at all post-index time points compared with pre-index (p< 0.05). Significantly lower adjusted HCRU costs for inpatient and outpatient visits were reported at all post-index time points compared with pre-index for children. For adults, significant reductions in adjusted costs were reported for emergency, inpatient, outpatient, and urgent care at all post-index time points when compared with pre-index. Total adjusted costs were significantly reduced from $473,857 at pre-index to $273,134 at 3 months post-index (p< 0.05) for children, and from $676,456 at pre-index to $427,576 at 6 months post-index (p< 0.001) for adults.Conclusion: Children and adults prescribed plant-based peptide formulas with fruit and vegetable ingredients showed significant reductions in GI intolerance symptoms, HCRU and associated costs post-hospital discharge.Keywords: pediatric nutrition, peptide tube feeding, healthcare resource utilization, real food enteral formulas, intolerance, real-world evidence