High-Protein Nutrition Drinks Could Save Millions in France Elders’ Care Costs

The researchers compared standard supplements with a more concentrated category described as highest high-energy, high-protein supplements.

For an older person recovering from illness at home, finishing a meal can become a daily struggle because appetite has faded, digestion is uncomfortable, or a few mouthfuls feel filling. Falling food intake can weaken muscles and make recovery harder, creating a cycle in which poor nutrition contributes to further health problems and hospital visits. The cost reached beyond the kitchen table, putting pressure on families and healthcare services.

The research paper "Economic value of high-energy, high-protein oral nutritional supplements in disease-related malnutrition in the French community setting," published in Frontiers in Nutrition, examines the financial value of nutrition drinks that pack more energy and protein into a smaller volume. Its cost model projects that France's existing mix of concentrated and standard supplements could save €17.4 million annually compared with using standard supplements alone, largely through lower hospital-related costs.

Why concentrated nutrition could make a difference

Disease-related malnutrition develops when illness reduces food intake, disrupts nutrient absorption or changes the body's nutritional needs. Older adults with frailty or sarcopenia, a condition involving declining muscle strength and mass, are particularly vulnerable because poor nutrition can deepen existing weakness and increase the need for care. The paper places the wider European Union economic burden of disease-related malnutrition at an estimated €120–170 billion each year.

Oral nutritional supplements provide additional energy and protein when ordinary food intake falls short. The practical challenge is that someone with little appetite may struggle to drink the volume needed from a standard product, making concentrated formulations potentially easier to fit into daily life. The researchers compared standard supplements with a more concentrated category described as highest high-energy, high-protein supplements.

Among the products included, a 200-millilitre bottle of a concentrated supplement supplied roughly 360–480 calories and about 20 grams to over 28 grams of protein. Standard products supplied about 250–300 calories and 7.5–20 grams of protein per bottle. This difference means more nutrition can be delivered in less liquid, which may help patients reach nutritional targets and continue treatment.

How the French healthcare costs were calculated

The researchers built an Excel-based calculator covering one year from the perspective of France's public healthcare payer, combining evidence from a systematic literature review with national population data, reimbursement prices and published healthcare costs. This was an economic modeling study, so its results represent estimates built from existing evidence rather than outcomes measured in a newly recruited patient group.

The model estimated an eligible population of 799,487 people aged 70 or older living at home with frailty or sarcopenia and disease-related malnutrition. It assumed that 40%, or about 319,795 people, received supplements. Within that treated group, the 2024 market mix was 73% concentrated products and 27% standard products, corresponding to approximately 233,450 and 86,345 patients, respectively.

Four scenarios covered no supplement use, standard supplements alone, the existing product mix and a mix with concentrated products reaching 80% of supplement use. Treatment coverage remained at 40% in the three scenarios involving supplements. Four formulations represented approximately 99% of 200-millilitre products used in 2024, and the calculator used a daily nutritional target of 500 calories and at least 30 grams of protein.

Both supplement categories were assigned 30 days of treatment, although the paper cites an average of 97 days in routine practice. Hospital admissions and length of stay were central to the calculations, with indirect comparisons used where direct evidence was missing. Complication costs included care associated with infections, pressure ulcers, diarrhoea and postoperative problems.

Where the projected €17.4 million saving comes from

For each treated patient, concentrated supplements were associated with modeled annual costs of €388, compared with €462 for standard products, producing a €74 difference. Supplement costs accounted for about €7 of that saving, falling from €96 to €89; complication-related costs accounted for approximately €67, falling from €366 to €299. Most of the financial advantage came from assumptions about reduced hospital use, including shorter stays and fewer readmissions.

Across the full eligible population, including people receiving no supplements, projected annual costs reached roughly €1.9 billion in the scenario without supplement use. Costs fell to approximately €1.288 billion with standard supplements available and €1.270 billion with the existing mix of concentrated and standard products. The difference between the two treatment scenarios produced the headline saving of about €17.4 million.

Increasing the concentrated products' share from 73% to 80% among existing supplement users generated another €1.7 million in projected annual savings. That scenario involved switching roughly a quarter of standard-product users to concentrated formulations, keeping overall treatment coverage unchanged. The researchers also explored changing key inputs individually by 20% in either direction; concentrated products remained less costly across the tested ranges, with hospital admission rates and length of stay exerting the strongest influence.

What the findings could mean for care

The results give healthcare planners a reason to examine nutritional screening, earlier support and the products covered by reimbursement systems. They suggest that a supplement's bottle price offers only part of the financial picture, because the amount required and subsequent hospital care can have a larger effect on total spending. The calculator can be adjusted to explore local populations, treatment patterns and costs.

Population estimates relied partly on proportional calculations because detailed data for people aged 70–74 were unavailable, and the clinical comparisons were not all based on direct studies of the two supplement categories. The 20% sensitivity ranges were exploratory choices rather than uncertainty limits established from observed data.

The analysis covered one year, used the same treatment duration for both categories and excluded caregiver burden, productivity losses and quality-of-life benefits. Its French cost structure also limits direct application elsewhere, and hospital residents and nursing-home populations were outside its scope. Nutricia funded the analysis, two authors were affiliated with Nutricia, and Clarivate received consultancy fees for economic modeling and medical writing.

The authors call for trials and studies using routine healthcare records to check the projected savings, alongside longer follow-up and assessments of patients' quality of life. Further work could examine cancer care, different levels of malnutrition, hospital and nursing-home settings, and other European health systems, giving decision-makers a clearer picture of where concentrated nutrition delivers the greatest value.