RT Journal Article
T1 Cost-effectiveness of positive airway pressure modalities in obesity hypoventilation syndrome with severe obstructive sleep apnoea.
A1 Masa, Juan F
A1 Mokhlesi, Babak
A1 Benitez, Ivan
A1 Gomez-de-Terreros-Caro, Francisco Javier
A1 Sanchez-Quiroga, M-Angeles
A1 Romero, Auxiliadora
A1 Caballero, Candela
A1 Alonso-Alvarez, Maria Luz
A1 Ordax-Carbajo, Estrella
A1 Gomez-Garcia, Teresa
A1 Gonzalez, Monica
A1 Lopez-Martin, Soledad
A1 Marin, Jose M
A1 Marti, Sergi
A1 Díiaz-Cambriles, Trinidad
A1 Chiner, Eusebi
A1 Egea, Carlos
A1 Barca, Javier
A1 Vazquez-Polo, Francisco-Jose
A1 Negrin, Miguel Angel
A1 Martel-Escobar, Maria
A1 Barbe, Ferran
A1 Corral-Peñafiel, Jaime
A1 Spanish Sleep Network, 
K1 non invasive ventilation
K1 sleep apnoea
AB 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. 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. 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. 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. CPAP is more cost-effective than NIV; therefore, CPAP should be the preferred treatment for patients with OHS with severe OSA. 
PB BMJ Group
YR 2020
FD 2020-05-15
LK http://hdl.handle.net/10668/15292
UL http://hdl.handle.net/10668/15292
LA en
NO Masa JF, Mokhlesi B, Benítez I, Gómez de Terreros Caro FJ, Sánchez-Quiroga MÁ, Romero A, et al. Cost-effectiveness of positive airway pressure modalities in obesity hypoventilation syndrome with severe obstructive sleep apnoea. Thorax. 2020 Jun;75(6):459-467.
DS RISalud
RD Apr 19, 2025