Up to 115,000 Patients May Be Malnourished Because of Illness, an Industry Group Warns, as State Cover for Clinical Feeding Rises to 90 Percent

About 115,000 people in Portugal, roughly 1 percent of the population, may be suffering from malnutrition linked to illness, and most hospital patients are never checked for it, according to the association that represents makers of clinical nutrition products. It welcomes the state's new reimbursement of tube and medical feeding, which rises to 90 percent next year, but warns that oral nutritional supplements are still largely left out.

Pedro Queiroz, secretary-general of the Associação Nacional da Indústria de Alimentação Infantil e Nutrição Entérica e Parentérica (ANID), gave the estimate to the Lusa news agency ahead of the association's National Clinical Nutrition Forum in Lisbon on Tuesday, which brought together specialists, health officials, patients and regulators.

Most inpatients are not screened

Estimates suggest that screening for disease-related malnutrition reaches only 31 percent of hospital inpatients, Queiroz said. In his view, the diagnosis has to be made in hospital so that treatment can start straight away. "The first big step is to increase screening, to actually identify the need, and then to improve access" to clinical nutrition, he said.

The ANID describes clinical nutrition as an essential part of treatment for many conditions, including inflammatory bowel disease, cancer, neurological illness, organ failure and recovery from surgery. Proper nutritional support, it says, reduces complications and hospital stays and improves outcomes and quality of life.

What the state now pays

Since the start of this year, patients who need enteral nutrition (specialised feeding given by mouth or through a tube to meet a patient's nutritional needs) have had 69 percent of the cost reimbursed by the state, under an exceptional reimbursement scheme. That share is due to rise to 90 percent next year.

Queiroz called this first step "very positive", but said a fundamental step remains: covering oral nutritional supplements as well. According to the ANID, the government order (portaria) on enteral nutrition already provides for those supplements to be reimbursed, but at only 15 percent in a first phase, and with no date set for that to begin.

The association says a 15 percent rate is a health policy measure but will hardly, on its own, guarantee real access for the patients who need these products. It wants the rate for oral supplements to rise in stages until it reaches the 90 percent planned for enteral nutrition.

The gap after discharge

The ANID's other concern is what happens when patients go home. Many of them are frail, chronically ill, disabled or children with complex conditions, and their nutritional therapy "cannot be interrupted", the association says. Moving from hospital to home requires coordination between teams, clear nutrition plans, training for carers, regular monitoring and guaranteed access to the prescribed products. "When these elements fail, the patient is left unprotected at a particularly vulnerable moment," Queiroz said.

What it means for patients and carers

The figures come from an industry body with an interest in wider reimbursement, and the 115,000 estimate is its own. The reimbursement rates, though, apply now. If you or someone you care for has been prescribed enteral nutrition, ask the prescribing doctor or the pharmacy how the 69 percent reimbursement is applied this year and whether your products qualify. For oral supplements, the 15 percent rate in the portaria still has no start date.

Medicine and nutrition costs are a recurring pressure on households: we reported this week on the argument over generic medicine prices for 2027.