COST-EFFECTIVENESS OF TREATMENTS FOR MILD-TO-MODERATE OBSTRUCTIVE SLEEP APNEA IN FRANCE
| Autor: | Hans-Martin Späth, Anne-Isabelle Poullié, M. Cognet, S. Druais, Aline Gauthier, Jean-Luc Harousseau, Catherine Rumeau Pichon, O. Scemama, Marine Clementz, Lionel Perrier |
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| Přispěvatelé: | Haute Autorité de Santé [Saint-Denis La Plaine] (HAS), Amaris, Amaris-Amaris London, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre Léon Bérard [Lyon], Groupe d'analyse et de théorie économique (GATE Lyon Saint-Étienne), Centre National de la Recherche Scientifique (CNRS)-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université Lumière - Lyon 2 (UL2)-École normale supérieure - Lyon (ENS Lyon), Groupe d'Analyse et de Théorie Economique Lyon - Saint-Etienne (GATE Lyon Saint-Étienne), École normale supérieure de Lyon (ENS de Lyon)-Université Lumière - Lyon 2 (UL2)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis medicine.medical_treatment Continuous positive airway pressure Excessive daytime sleepiness Severity of Illness Index JEL: I - Health Education and Welfare/I.I1 - Health/I.I1.I18 - Government Policy • Regulation • Public Health 03 medical and health sciences 0302 clinical medicine Quality of life Severity of illness medicine Humans Life Style Sleep Apnea Obstructive business.industry Cost-effectiveness analysis 030503 health policy & services Health Policy Accidents Traffic Health Services Middle Aged Dental devices [SHS.ECO]Humanities and Social Sciences/Economics and Finance medicine.disease Obstructive sleep apnea Markov Chains Quality-adjusted life year Cardiovascular Diseases Emergency medicine Quality of Life Physical therapy Mouth Protectors Patient Compliance Female France Quality-Adjusted Life Years medicine.symptom 0305 other medical science business Models Econometric 030217 neurology & neurosurgery |
| Zdroj: | International Journal of Technology Assessment in Health Care International Journal of Technology Assessment in Health Care, Cambridge University Press (CUP), 2016, 32 (1), pp. 1-9. ⟨10.1017/S0266462316000088⟩ International Journal of Technology Assessment in Health Care, 2016, 32 (1), pp. 1-9. ⟨10.1017/S0266462316000088⟩ |
| ISSN: | 1471-6348 0266-4623 |
| Popis: | Objectives: Untreated obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with excessive daytime sleepiness, increased risk of cardiovascular (CV) disease, and road traffic accidents (RTAs), which impact survival and health-related quality of life. This study, funded by the French National Authority for Health (HAS), aimed to assess the cost-effectiveness of different treatments (i.e., continuous positive airway pressure [CPAP], dental devices, lifestyle advice, and no treatment) in patients with mild-to-moderate OSAHS in France.Methods: A Markov model was developed to simulate the progression of two cohorts, stratified by CV risk, over a lifetime horizon. Daytime sleepiness and RTAs were taken into account for all patients while CV events were only considered for patients with high CV risk.Results: For patients with low CV risk, incremental cost-effectiveness ratio (ICER) of dental devices versus no treatment varied between 32,976 EUR (moderate OSAHS) and 45,579 EUR (mild OSAHS) per quality-adjusted life-year (QALY), and CPAP versus dental devices, above 256,000 EUR/QALY. For patients with high CV risk, CPAP was associated with a gain of 0.62 QALY compared with no treatment, resulting in an ICER of 10,128 EUR/QALY.Conclusion: The analysis suggests that it is efficient to treat all OSAHS patients with high CV risk with CPAP and that dental devices are more efficient than CPAP for mild-to-moderate OSAHS with low CV risk. However, out-of-pocket costs are currently much higher for dental devices than for CPAP (i.e., 3,326 EUR versus 2,430 EUR) as orthodontic treatment is mainly non-refundable in France. |
| Databáze: | OpenAIRE |
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