PMID- 37041933
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230915
IS  - 1178-6981 (Print)
IS  - 1178-6981 (Electronic)
IS  - 1178-6981 (Linking)
VI  - 15
DP  - 2023
TI  - Cost-Effectiveness of Humidified High-Flow Therapy (HHFT) for COPD Patients on 
      Long-Term Oxygen Therapy.
PG  - 239-250
LID - 10.2147/CEOR.S400739 [doi]
AB  - PURPOSE: Chronic obstructive pulmonary disease (COPD) is the third leading cause 
      of mortality, and is associated with significant respiratory impairment, 
      decreased quality of life, and high health care costs. Recent evidence indicates 
      significant clinical benefit results from adding humidified high-flow therapy 
      (HHFT) to standard long-term oxygen therapy (LTOT) as a home-based therapy in 
      persons with severe COPD. The objective was to evaluate the cost-effectiveness of 
      adding HHFT to standard treatment of COPD patients using LTOT with US healthcare 
      cost estimates. PATIENTS AND METHODS: A Markov state-transition model was 
      developed using data from a prospective clinical trial of adding HHFT to standard 
      therapy for persons with severe COPD using LTOT. The analysis was conducted from 
      the US health care system perspective using a 5-year time horizon and 3% discount 
      rate. QALYs and downstream healthcare costs were modeled. One-way and 
      probabilistic sensitivity analyses were used to examine the impact of input 
      parameters on the incremental net monetary benefit (NMB). RESULTS: Incremental 
      QALYs accrued were 0.058 (2.047 vs 1.989 QALYs for HHFT and standard therapy 
      groups respectively). Incremental total costs were -$3939 ($47,516 vs $51,455 for 
      HHFT and standard therapy groups respectively). Thus, HHFT was the dominant 
      treatment in the analysis, resulting on both better health and lower total costs. 
      Varying utility and cost inputs individually never resulted in NMB approaching 0. 
      Probabilistic analyses indicate that HHFT is cost-effective in 84% of 
      simulations. CONCLUSION: Our results indicate that the reductions in acute 
      exacerbations of COPD (AECOPDs) that result from adding HHFT for persons with 
      COPD on LTOT will produce both health benefit (QALYs) and cost savings. Cost 
      savings occur because the HHFT device costs are more than offset by reductions in 
      costly COPD exacerbations. Health care systems and payors can benefit from wider 
      implementation of HHFT with existing treatments.
CI  - (c) 2023 Groessl et al.
FAU - Groessl, Erik J
AU  - Groessl EJ
AUID- ORCID: 0000-0001-6239-1965
AD  - Health Services Research Center, Herbert Wertheim School of Public Health and 
      Human Longevity Science, University of California, San Diego, CA, USA.
AD  - VA San Diego Healthcare System, San Diego, CA, USA.
FAU - Tally, Steven R
AU  - Tally SR
AD  - Health Services Research Center, Herbert Wertheim School of Public Health and 
      Human Longevity Science, University of California, San Diego, CA, USA.
FAU - Hillery, Naomi
AU  - Hillery N
AD  - Health Services Research Center, Herbert Wertheim School of Public Health and 
      Human Longevity Science, University of California, San Diego, CA, USA.
LA  - eng
PT  - Journal Article
DEP - 20230405
PL  - New Zealand
TA  - Clinicoecon Outcomes Res
JT  - ClinicoEconomics and outcomes research : CEOR
JID - 101560564
EIN - Clinicoecon Outcomes Res. 2023 May 15;15:331-332. PMID: 37214083
PMC - PMC10083032
OTO - NOTNLM
OT  - COPD
OT  - acute exacerbations
OT  - cost-effectiveness
OT  - humidified high flow therapy
COIS- Dr Erik J Groessl reports personal fees from Fisher Paykel Inc., during the 
      conduct of the study. The authors report no other conflicts of interest in this 
      work.
EDAT- 2023/04/13 06:00
MHDA- 2023/04/13 06:01
PMCR- 2023/04/05
CRDT- 2023/04/12 01:45
PHST- 2022/12/08 00:00 [received]
PHST- 2023/03/04 00:00 [accepted]
PHST- 2023/04/13 06:01 [medline]
PHST- 2023/04/12 01:45 [entrez]
PHST- 2023/04/13 06:00 [pubmed]
PHST- 2023/04/05 00:00 [pmc-release]
AID - 400739 [pii]
AID - 10.2147/CEOR.S400739 [doi]
PST - epublish
SO  - Clinicoecon Outcomes Res. 2023 Apr 5;15:239-250. doi: 10.2147/CEOR.S400739. 
      eCollection 2023.