With proper compliance, CPAP is clinically effective, but is it cost effective? Researchers at the INOVA Fairfax Hospital, Fairfax, Va, believe the answer is yes.
In the study which will appears in the May edition of Sleep Diagnosis and Therapy, lead researcher Mahadevappa Hunasikatti, MD, DPM, FCCP, factored in direct and indirect (work-related injuries, lost work productivity) costs to determine that CPAP compared favorably with many medical treatments, such as cholesterol lowering medications and biologic agents in the treatment of rheumatoid arthritis.
“Untreated OSA leads to multiple medical problems such as hypertension, cardiovascular disease, injuries, and mood disorders that potentially increase medical care utilization,” concludes Hunasikatti. “Mean medical costs of patients with OSA were significantly greater ($ 2720) than those of matched controls ($1384).”
In addition, cost effectiveness of CPAP was compared to dental devices and life style advice for adults. “On average, CPAP was associated with higher cost and Quality –adjusted life-year (QALY) compared to dental devices or life style,” wrote researchers. “In the case base case analysis the incremental cost effectiveness of ratio (ICER) for CPAP compared to dental devices was around 4,000 pounds per QALY (2005-06 prices). The probability that CPAP is more cost effective than dental devices or life style advice at a threshold value of 20,000 pounds per QALY was 0.78 for men and 0.80 for women.”
As for CPAP’s effect on the financial health of the nation, CPAP results in long-term health benefit, as measured by the use of health care services. “The CPAP is also cost effective in American context where they used Markov model and found that ICER of CPAP was found to be $3,354 dollars per QALY,” wrote researchers.