Medical Nutrition International Industry Association (MNI) is pleased to inform you of the recent publication of a White Paper on factors contributing to unequal patient access to home parenteral nutrition (HPN).  ​​​​​​​

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

Download the White Paper

Background

MNI recently sought an up-to-date understanding of the current landscape of HPN use across Europe, specifically among adult patients falling within one of the ESPEN-defined categories of patients suitable for HPN.

A qualitative survey was therefore carried out between February and July of 2021. The survey comprised a total of 22 interviews across nine European countries including Belgium, Croatia, Denmark, France, Germany, Italy, Netherlands, Poland, and Spain. Stakeholders of interest included clinicians, specialist nurses, or academic HPN experts. In each country, at least one payer or policy-maker was interviewed.

This white paper provides:

• The key findings of the survey
• Three important calls to action that MNI believes are crucial to achieving equitable access to HPN across Europe.

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.