Procurement of oral nutritional supplements (ONS) for IBD in Italy: regional variation associated with exclusion from the Essential Levels of Care (LEA)
Poster presented at the 14th SIFaCT Congress, Trento, October 8–10, 2026
The objective of this study is to analyze the extent to which the exclusion of ONS (oral nutritional supplements) intended for patients with Inflammatory Bowel Disease (IBD) from the Essential Levels of Care (LEA) affects regional differences in procurement. To do so, the study compares the procurement requirements specified in regional tenders with the actual prevalence of malnourished patients in each region. ESPEN guidelines recommend ONS as a first-line treatment for malnutrition. In Italy, however, their provision is delegated to individual regions. A retrospective analysis of regional public tenders for enteral nutrition (2023–2025) shows a national average purchase of 951.8 g per patient per year. This amount corresponds to approximately 13 kcal per day, compared to the 400 kcal per day recommended by ESPEN for malnourished IBD patients. There is marked variability among the regions, associated with the exclusion of ONS from the Essential Levels of Care (LEA) and regional discretion. Including ONS for IBD in the LEA would help bridge the gap with the guidelines and ensure uniform access throughout the country.
Authors:
- Valentina Pagella, Lionhealth Società Benefit
- Fatima Zafar, Lionhealth Società Benefit
- Elena P. Lanati, CEO and Founder Lionhealth Società Benefit
