Cost-utility and budget impact analysis of CPAP therapy compared to no treatment in the management of moderate to severe obstructive sleep apnea in Colombia from a third-party payer perspective

ABSTRACT

Objectives

To conduct cost-utility and budget impact analysis of providing Continuous Positive Airway Pressure (CPAP) therapy versus no treatment for moderate to severe obstructive sleep apnea (OSA) in Colombia from a third-party payer perspective.

Methods

We used a Markov model to assess the cost-utility and budget impact analysis of CPAP in patients over 40 years old with moderate to severe OSA. Data on effectiveness and utility values were obtained from published literature. A discount rate of 5% was applied for outcomes and costs. ICER was calculated and compared against the threshold estimated for Colombia, which is 86% of the GDP per capita.

Results

Over a lifetime horizon, the base case analysis showed the incremental cost per quality-adjusted life-years (QALYs) gained with CPAP therapy was COP$3,503,804 (USD$1,011 in 2020 prices). The budget impact analysis showed that the adoption of CPAP therapy in the target population would lead to a cumulative net budget impact of COP$411,722 million (USD$118,784,412 in, 2020 prices) over five years of time horizon.

Conclusions

CPAP was cost-effective compared to no-treatment in OSA. According to the budget impact analysis, adopting this technology would require a budget allocation that is partially offset by reduced number of strokes and traffic accident events.

KEYWORDS:

• Budget impact
• continuous positive airway pressure
• cost-effectiveness analysis
• excessive daytime sleepiness
• obstructive sleep apnea

Declaration of interest

Funding by this project was provided from ResMed Colombia. The research and reporting of the findings were in no way dictated or otherwise influenced by ResMed Colombia. Grants were paid to IQVIA. Y Gil-Rojas, D Amaya, F Hernandez and A Robles are employees of IQVIA, the company that was awarded the contract to conduct the study. F Escobar-Cordoba, M Venegas, J Echeverry and S Zabala declare a relationship with ResMed Colombia in all support for the present manuscript (e.g. funding, provision of study materials, medical writing, article processing charges, etc.). S Restrepo declare a disclosure for Advisory board RESMED to ACMES. M Bazurto-Zapata declare that ResMed paid ACMES for advisory board (Colombian Sleep Medicine Association). M Deger is a ResMed employee and owns ResMed Stocks. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

A Robles contributed to the concept and design of the manuscript, acquisition, analysis, and interpretation of data and statistical analysis. Y Gil-Rojas and D Amaya contributed to acquisition, analysis and interpretation of data, drafting of the manuscript and statistical analysis. F Hernandez contributed to the concept and design of the study, logistic support, supervision and critical revision of the manuscript. F Escobar-Cordoba, M Venegas, S Amado, S Restrepo, J Echeverry and F Marin were involved in acquisition, analysis and critical revision of the manuscript. M Bazurto-Zapata, S Zabala, M Deger contributed to the concept and design of the study, acquisition of data, analysis and critical revision of the manuscript. All the authors and were involved in revising it critically for intellectual content and agreed with the final version of the manuscript to be published.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2181792

Additional information

Funding

This study was funded by ResMed Colombia.