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ResMed demonstrate cost effectiveness of combining home oxygen therapy and home NIV therapy

MDBR Staff Writer Published 21 May 2018

ResMed-sponsored studies show combining home oxygen and home non-invasive ventilation is a cost effective treatment for chronic obstructive pulmonary disease (COPD).

The company presented its studies on Home Oxygen Therapy – Home Mechanical Ventilation (HOT-HMV) health economic studies at the ATS 2018 International Conference.

The presentation builds on earlier data showing clinical and cost effectiveness of HOT HMV therapy, that combines therapy with home NIV, compared to treating with oxygen alone.

The UK study found that HOT-HMV treatment has reduced exacerbation frequency and 28-day hospital readmission. The US analysis found a 58.3% reduction in 30-day readmissions for HOT-HMV patients compared to those on home oxygen alone. HOT-HMW can be financially beneficial for patients while improving their quality of life.

ResMed chief medical officer Carlos M. Nunez said: “It’s common for a procedure or therapy to improve patient outcomes and quality of life, but it’s rare to have a significant clinical impact with such a favorable economic impact as well, as HOT-HMV does.

“This finding is very positive news for people living with COPD who could benefit from HOT-HMV. The cost-saving potential is one more factor for encouraging wider use of this therapy option.”

Cost-Effectiveness of Home Oxygen Therapy – Home Mechanical Ventilation (HOT-HMV) for the Treatment of Chronic Obstructive Pulmonary Disease (COPD) with Chronic Hypercapnic Respiratory Failure Following an Acute Exacerbation of COPD in the United Kingdom (UK), is an economic analysis, which is based on patient-level medical resource utilization (MRU) from the intention-to-treat analysis of an open-label parallel-group randomized clinical trial.

Patients with a hospital admission because of exacerbation of COPD that need acute home mechanical ventilation (non-invasive ventilation, or NIV) with persistent hypercapnia 2–4 weeks after resolution of respiratory acidosis were enrolled for the study.

Patients in the control arm were permitted to have NIV added to home oxygen therapy if the primary end-point (hospital readmission) was met and if pre-set safety criteria were breached (for example, persistent acidosis and inability to wean from NIV).

The MRU analysis included patient-level evaluation of equipment (oxygen concentrator and NIV device, including maintenance and support), patient-reported medication, physician office visits, and hospital readmissions due to exacerbations.

The trial data was used to develop an economic model from the UK National Health Service perspective and costs were calculated by multiplying observed MRU by standard unit costs (2017£) and summed at the patient level.

From the trial, quality-adjusted life years (QALYs) were also measured based on patient health utilities calculated with UK coefficients and EuroQOL-5D data from the trial.

The analysis in the US was based on the UK study. The trial data was used for developing an economic model from the perspective of a US payer.