Cargando…

Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations

INTRODUCTION: COPD places a huge clinical and economic burden on the US health care system, with acute exacerbations representing a key driver of direct medical costs. Current treatments, although effective in reducing symptoms and limiting exacerbations, do not adequately target the underlying dise...

Descripción completa

Detalles Bibliográficos
Autores principales: Khoudigian-Sinani, Shoghag, Kowal, Stacey, Suggett, Jason A, Coppolo, Dominic P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655131/
https://www.ncbi.nlm.nih.gov/pubmed/29089755
http://dx.doi.org/10.2147/COPD.S143334
_version_ 1783273472309329920
author Khoudigian-Sinani, Shoghag
Kowal, Stacey
Suggett, Jason A
Coppolo, Dominic P
author_facet Khoudigian-Sinani, Shoghag
Kowal, Stacey
Suggett, Jason A
Coppolo, Dominic P
author_sort Khoudigian-Sinani, Shoghag
collection PubMed
description INTRODUCTION: COPD places a huge clinical and economic burden on the US health care system, with acute exacerbations representing a key driver of direct medical costs. Current treatments, although effective in reducing symptoms and limiting exacerbations, do not adequately target the underlying disease processes that drive exacerbation development. The Aerobika* oscillating positive expiratory pressure (OPEP) device has been shown in a real-world effectiveness study to lower the frequency of moderate-to-severe exacerbations during a 30-day post-exacerbation period. This study sought to determine the impact on exacerbations and costs and to determine the cost-effectiveness of the Aerobika* device. METHODS: Data from published literature and national fee schedules were used to model the cost-effectiveness of the Aerobika* device in patients who had experienced an exacerbation in the previous month, or a post-exacerbation care population. Exacerbation trends and the impact of the Aerobika* device on reducing exacerbation frequency were modeled using a one-year Markov model with monthly cycles and three health states: (i) no exacerbation, (ii) exacerbation, and (iii) death. Scenario analysis and one-way sensitivity analysis (OWSA) were also performed. RESULTS: When the effect of Aerobika* device was assumed to last 30 days, use of the device resulted in cost-savings ($553 per patient) and improved outcomes (ie, six fewer exacerbations per 100 patients per year) compared to no OPEP/positive expiratory pressure therapy. When the effect of the Aerobika* device was assumed to extend beyond the conservative 30-day time frame, the Aerobika* device remained the dominant strategy (21 fewer exacerbations per 100 patients per year; cost savings of $1,952 per patient). Consistency in findings after performing OWSAs indicates the robustness of results. CONCLUSION: The Aerobika* device is a cost-effective treatment option that provides clinical benefit and results in direct medical cost savings in a post-exacerbation care COPD population.
format Online
Article
Text
id pubmed-5655131
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-56551312017-10-31 Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations Khoudigian-Sinani, Shoghag Kowal, Stacey Suggett, Jason A Coppolo, Dominic P Int J Chron Obstruct Pulmon Dis Original Research INTRODUCTION: COPD places a huge clinical and economic burden on the US health care system, with acute exacerbations representing a key driver of direct medical costs. Current treatments, although effective in reducing symptoms and limiting exacerbations, do not adequately target the underlying disease processes that drive exacerbation development. The Aerobika* oscillating positive expiratory pressure (OPEP) device has been shown in a real-world effectiveness study to lower the frequency of moderate-to-severe exacerbations during a 30-day post-exacerbation period. This study sought to determine the impact on exacerbations and costs and to determine the cost-effectiveness of the Aerobika* device. METHODS: Data from published literature and national fee schedules were used to model the cost-effectiveness of the Aerobika* device in patients who had experienced an exacerbation in the previous month, or a post-exacerbation care population. Exacerbation trends and the impact of the Aerobika* device on reducing exacerbation frequency were modeled using a one-year Markov model with monthly cycles and three health states: (i) no exacerbation, (ii) exacerbation, and (iii) death. Scenario analysis and one-way sensitivity analysis (OWSA) were also performed. RESULTS: When the effect of Aerobika* device was assumed to last 30 days, use of the device resulted in cost-savings ($553 per patient) and improved outcomes (ie, six fewer exacerbations per 100 patients per year) compared to no OPEP/positive expiratory pressure therapy. When the effect of the Aerobika* device was assumed to extend beyond the conservative 30-day time frame, the Aerobika* device remained the dominant strategy (21 fewer exacerbations per 100 patients per year; cost savings of $1,952 per patient). Consistency in findings after performing OWSAs indicates the robustness of results. CONCLUSION: The Aerobika* device is a cost-effective treatment option that provides clinical benefit and results in direct medical cost savings in a post-exacerbation care COPD population. Dove Medical Press 2017-10-19 /pmc/articles/PMC5655131/ /pubmed/29089755 http://dx.doi.org/10.2147/COPD.S143334 Text en © 2017 Khoudigian-Sinani et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Khoudigian-Sinani, Shoghag
Kowal, Stacey
Suggett, Jason A
Coppolo, Dominic P
Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations
title Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations
title_full Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations
title_fullStr Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations
title_full_unstemmed Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations
title_short Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations
title_sort cost-effectiveness of the aerobika* oscillating positive expiratory pressure device in the management of copd exacerbations
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655131/
https://www.ncbi.nlm.nih.gov/pubmed/29089755
http://dx.doi.org/10.2147/COPD.S143334
work_keys_str_mv AT khoudigiansinanishoghag costeffectivenessoftheaerobikaoscillatingpositiveexpiratorypressuredeviceinthemanagementofcopdexacerbations
AT kowalstacey costeffectivenessoftheaerobikaoscillatingpositiveexpiratorypressuredeviceinthemanagementofcopdexacerbations
AT suggettjasona costeffectivenessoftheaerobikaoscillatingpositiveexpiratorypressuredeviceinthemanagementofcopdexacerbations
AT coppolodominicp costeffectivenessoftheaerobikaoscillatingpositiveexpiratorypressuredeviceinthemanagementofcopdexacerbations