Please use this identifier to cite or link to this item:
Title: Cost-effectiveness of positive airway pressure modalities in obesity hypoventilation syndrome with severe obstructive sleep apnoea
Authors: Masa, Juan F
Mokhlesi, Babak
Benítez, Iván
Gómez de Terreros Caro, Francisco Javier
Sánchez-Quiroga, M-Ángeles
Romero, Auxiliadora
Caballero, Candela
Alonso-Álvarez, Maria Luz
Ordax-Carbajo, Estrella
Gómez-García, Teresa
González, Mónica
López-Martín, Soledad
Marin, Jose M
Martí, Sergi
Díaz-Cambriles, Trinidad
Chiner, Eusebi
Egea, Carlos
Barca, Javier
Vázquez Polo, Francisco José 
Negrín Hernández, Miguel Ángel 
Martel Escobar, María Carmen 
Barbé, Ferran
Corral-Peñafiel, Jaime
UNESCO Clasification: 530202 Modelos econométricos
531207 Sanidad
Keywords: Enfermedades respiratorias
Análisis coste beneficio
Estadística bayesiana
Issue Date: 2020
Project: PI050402, Spanish Respiratory Foundation 2005 (FEPAR) and Air Liquide Spain
Journal: Thorax 
Abstract: Background Obesity hypoventilation syndrome (OHS) is treated with either non-invasive ventilation (NIV) or CPAP, but there are no long-term cost-effectiveness studies comparing the two treatment modalities. Objectives We performed a large, multicentre, randomised, open-label controlled study to determine the comparative long-term cost and effectiveness of NIV versus CPAP in patients with OHS with severe obstructive sleep apnoea (OSA) using hospitalisation days as the primary outcome measure. Methods Hospital resource utilisation and within trial costs were evaluated against the difference in effectiveness based on the primary outcome (hospitalisation days/year, transformed and non-transformed in monetary term). Costs and effectiveness were estimated from a log-normal distribution using a Bayesian approach. A secondary analysis by adherence subgroups was performed. Results In total, 363 patients were selected, 215 were randomised and 202 were available for the analysis. The median (IQR) follow-up was 3.01 (2.91-3.14) years for NIV group and 3.00 (2.92-3.17) years for CPAP. The mean (SD) Bayesian estimated hospital days was 2.13 (0.73) for CPAP and 1.89 (0.78) for NIV. The mean (SD) Bayesian estimated cost per patient/year in the NIV arm, excluding hospitalisation costs, was €2075.98 (91.6), which was higher than the cost in the CPAP arm of €1219.06 (52.3); mean difference €857.6 (105.5). CPAP was more cost-effective than NIV (99.5% probability) because longer hospital stay in the CPAP arm was compensated for by its lower costs. Similar findings were observed in the high and low adherence subgroups. Conclusion CPAP is more cost-effective than NIV; therefore, CPAP should be the preferred treatment for patients with OHS with severe OSA. Trial registration number NCT01405976 © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions
ISSN: 0040-6376
DOI: 10.1136/thoraxjnl-2019-213622
Source: Thorax [0040-6376], v. 75(6), p. 439-440
Appears in Collections:Artículos
Adobe PDF (1,47 MB)
Show full item record

Google ScholarTM




Export metadata

Items in accedaCRIS are protected by copyright, with all rights reserved, unless otherwise indicated.