There is unequal access to home parenteral nutrition in Europe - MNI White Paper
Despite the proven benefits of home parenteral nutrition (HPN), the extent to which it is used across Europe varies markedly. Reasons for this include:
- The absence of legislative frameworks to support the provision of HPN
- Inconsistent enforcement of legislation when such a framework does exist
- Mixed acceptance and implementation of HPN clinical guidelines
- A lack of reimbursement for the intervention
In this white paper, with the goal of achieving equal patient access to HPN across Europe, the Medical Nutrition International Industry association (MNI) issues three crucial calls to action:
1. To achieve equitable patient access to HPN across Europe:
- Common frameworks for supportive legislation need to be established
- HPN clinical guidelines need to be more consistently implemented
- Further reimbursement for HPN must be provided
- The management, organisation, and delivery of HPN all need to improve
2. Greater efforts are needed to better educate and inform decision-makers of current evidence and expert opinion in treatment guidelines. Improving adherence with treatment guidelines will lead to improved access to HPN among those patients who need it. ESPEN guidelines provide evidence-based recommendations on the appropriate and safe use of HPN. Nonetheless, the degree to which these guidelines are used across Europe varies.
3. Action is needed by payers to address setting, indication, and regional reimbursement limitations to improve patient access to HPN.