期刊
THORAX
卷 63, 期 10, 页码 860-865出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/thx.2007.086454
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-
资金
- ResMed, Oxfordshire, UK
Objective: A study was undertaken to estimate the cost-effectiveness of using continuous positive airway pressure (CPAP) in the management of patients with severe obstructive sleep apnoea/hypopnoea syndrome (OSAHS) compared with no treatment from the perspective of the UK's National Health Service (NHS). Methods: A Markov model was constructed to assess the cost-effectiveness of CPAP compared with no treatment. The model depicted the management of a 55-year-old patient with severe OSAHS as defined by an apnoea-hypopnoea index (AHI) >30 and daytime sleepiness (Epworth Sleepiness Scale score >= 12). The model spans a period of 14 years. Results: According to the model, 57% of untreated patients are expected to be alive at the end of 14 years compared with 72% of patients treated with CPAP. Untreated patients are expected to cost the NHS 10 pound 645 (95% CI 7988 pound to 14 pound 098) per patient over 14 years compared with 9672 pound (95% CI 8057 pound to 12 pound 860) per CPAP-treated patient. Treatment with CPAP for a period of 1 year was found not to be a cost-effective option since the cost per quality-adjusted life year (QALY) gained is expected to be >20 pound 000, but after 2 years of treatment the cost per QALY gained is expected to be 10 pound 000 or less and, after 13 years of treatment, CPAP becomes a dominant treatment (ie, more effective than no treatment for less cost). Conclusion: Within the limitations of the model, CPAP was found to be clinically more effective than no treatment and, from the perspective of the UK's NHS, a cost-effective strategy after a minimum of 2 years of treatment.
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