Economic impact analysis of a minimally invasive temperature-controlled radiofrequency device versus nasal surgery for the treatment of nasal airway obstruction in the United States

Abstract

Objective

To determine the economic impact of a minimally invasive temperature-controlled radiofrequency (TCRF) device for treating nasal airway obstruction (NAO).

Methods

A budget impact model was developed for two scenarios: a reference scenario of functional rhinoplasty surgery with concomitant septoplasty and inferior turbinate reduction (ITR) performed in the hospital outpatient department where TCRF is not an available treatment option and a new scenario consisting of in-office TCRF treatment of the nasal valve and ITR. A payor perspective was adopted with a hypothetical population plan size of one million members. Costs were estimated over a time horizon of 4 years. The eligible population included patients with severe/extreme NAO and nasal valve collapse (NVC) as the primary cause or significant contributor. Data inputs were sourced from targeted literature reviews. Uncertainty within the model structure and input parameters was assessed using one-way sensitivity analysis.

Results

The introduction of a TCRF device resulted in population-level cost savings of $20,015,123 and per-responder average cost savings of $3531 through a 4-year time horizon due to lower procedure costs and complication rates of the device relative to the surgical comparator. Results were robust when varying parameter values in sensitivity analyses, with cost savings being most sensitive to the prevalence of NAO and estimated response rates to functional rhinoplasty and TCRF.

Conclusions

In patients with severe/extreme NAO, with NVC as the primary or major contributor, introducing TCRF with ITR as a treatment option demonstrates the potential for significant cost savings over functional rhinoplasty with septoplasty and ITR.

PLAIN LANGUAGE SUMMARY

Nasal valve dysfunction is a common cause of nasal airway obstruction (NAO) that has a significant impact on heath and quality of life for affected individuals. Previously, patients were offered temporary measures or a type of surgery called functional rhinoplasty which is a highly complex surgery that can be costly, requires recovery time, and in rare cases, not be successful. Recently, a new minimally invasive treatment alternative for NAO called temperature-controlled radiofrequency (TCRF) that may be performed in a surgery center or a doctor’s office has become available. This paper provides the results of budget impact analysis performed to assess whether adding the TCRF procedure in place of surgery as a choice for patients with NAO will result in cost savings to an insurance payer with 1 million covered individuals in the United States over a period of 4 years. Results show that TCRF may result in an average of 9,416 fewer rhinoplasty surgeries, provide an average 4-year cost-savings of $3,531 for every patient that responds to TCRF treatment, and a savings of $20,015,123 over 4 years for the insurance provider. These potential cost savings over 4 years would likely be due to reduced procedure costs and complication rates compared to surgery.

Keywords:

• Economic impact
• nasal valve
• nasal airway obstruction
• rhinoplasty
• inferior turbinate
• septal swell body
• temperature-controlled radiofrequency

JEL CLASSIFICATION CODES:

• I10
• I1
• I
• I19

Transparency

Declaration of funding

Aerin Medical funded this study and will sponsor the open access for the publication.

Declaration of financial/other relationships

DH, JB, and SW are employees of Aerin Medical. AH, SB, AF, RH, and GB are employees of Adelphi Values PROVE. GS is an independent consultant who supported this study and is contracted through Adelphi Values PROVE. MY is an employee of Stanford University. RO is an employee of SacENT and is a consultant for Aerin Medical.

Author contributions

All authors read and approved the final version of this manuscript. Concept and design: AH, SB, AF, GS, RH. Acquisition of data: DH. Analysis and interpretation of data: AH, SB, AF, GS, RH, GB, MY, DH, RO. Drafting of the manuscript: AH, SB, AF, GS, RH, GB. Critical revision of the paper for important intellectual content: MY, DH, JB, SW, RO. Administrative, technical, or logistic support: AH, SB, AF, GS, RH, GB. Supervision: DH.

Acknowledgements

The authors thank Adeola Sanni, an independent consultant to Aerin Medical, for assistance with manuscript preparation.

Data availability statement

All data used in this study may be made available upon request.

Reviewer disclosures

Peer reviewers on this manuscript have received an honorarium from JME for their review work but have no other relevant financial relationships to disclose.