If the clinical effectiveness of home-based NIV treatment is backed up by studies(1,2), questions over its cost-effectiveness are still a barrier when it comes to prescribing it. In this webinar, our guests Dr. Eline Gantzhorn and Dr. Patrick Murphy discuss the cost per QALY (Quality-Adjusted Life Year) of home-based COPD treatment and its implications for future use. In particular, they look at the variable factors across patients and geographical regions.
For Dr. Gantzhorn, there needs to be a goal, a quantifiable target in terms of CO2 reduction if the benefits – in this case a drop in mortality – are to be fully recognized.
For Dr. Murphy, the value of home NIV needs to be seen in the context of the other initiatives being taken to address respiratory disease. He points to the fact that smoking rates are still high and that the general decrease in smoking over recent decades has levelled off in the last two years. He believes home NIV is truly cost-effective when used on the right patients, those with the most frequent admissions and/or with chronic hypercapnia.
Our guests discuss the comparison of cost-effectiveness in different countries: in the US, where, as Dr. Murphy points out, hospital intervention is relatively more expensive but the cost of respiratory devices is lower, the cost-effectiveness of home NIV is much greater than in the UK.
Also discussed in the webinar is a comparison between home-based NIV and the other therapies being prescribed, such as Triple Inhaled Therapy. As Dr. Murphy explains, there are misconceptions within the medical care community:
“Lots of people are put off referring patients for home ventilation because of a perceived cost barrier. In the context of the other interventions we use for COPD, cost effectiveness should not be seen as a barrier because it (home-based NIV) is clinically and cost-effective.”
Also among the topics are the outlook for home NIV and the chances of its wider future adoption.
For an insightful conversation on home-based NIV therapy’s value to patients and HCP’s alike, you can watch the full webinar in the player above.
1 Köhnlein T, et al. Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med 2014;2:698-705.
2 Murphy P, et al. Effect of Home Noninvasive Ventilation With Oxygen Therapy vs Oxygen Therapy Alone on Hospital Readmission or Death After an Acute COPD Exacerbation. A Randomized Clinical Trial. JAMA 2017;317:2177-2186.