Cost-Effectiveness of Humidified High-Flow Therapy (HHFT) for COPD Patients on Long-Term Oxygen Therapy

Figures & data

Figure 1 Markov model of event outcomes for HHFT + LTOT vs standard LTOT therapy.

Table 1 Model Inputs

Parameters	Distribution	Annual	Monthly	Low	High	Reference/Source
Test inputs
Moderate COPD Exacerbation rate - HHFT + LTOT	Triangular	2.04	0.170	0.140	0.210	[17]
Moderate COPD Exacerbation rate - LTOT	Triangular	3.73	0.311	0.226	0.340	[17]
Severe COPD Exacerbation rate - myAirvo + LTOT	Triangular	1.08	0.090	0.053	0.079	[17]
Severe COPD Exacerbation rate- LTOT	Triangular	1.22	0.102	0.097	0.139	[17]
Clinical inputs
Age of patient at baseline	Fixed	71	–	–	–	[17]
Mortality rates (no difference between conditions)	Fixed	0.12	0.01			[17]
Cost inputs, $
Initial healthcare cost (one time cost)	Triangular	Per patient	$400	$320	$480	[39,40]
HHFT Device costs and consumables	Triangular	$1872	$156	$125	$187	[38]
Incremental health care cost – Moderate AECOPD	Gamma	Per event	$770	$385	$1155	[41]
Incremental health care cost – Severe AECOPD	Gamma	Per event	$11,229	$5614	$16,844	[41]
Utility inputs
COPD needing LTOT – no exacerbation	Triangular	0.630	0.0525	0.0420	0.0630	[31–33]
COPD needing LTOT – moderate exacerbation	Triangular	0.536	0.0446	0.0358	0.0536	[34–36]
COPD needing LTOT – severe exacerbation	Triangular	0.315	0.0263	0.0210	0.0315	[34–36]
Policy inputs
Time horizon	60 months
Discount rate	3%

Abbreviations: COPD, chronic obstructive pulmonary disorder; LTOT, long term oxygen therapy; AECOPD, acute exacerbation of chronic obstructive pulmonary disorder.

Table 2 Incremental Costs and QALYs of LTOT + HHFT to LTOT Alone

	HHFT + LTOT	LTOT	Difference
Effectiveness
QALYs	2.047	1.989	0.058
Costs
Initial Physician and RT visit	$400	$0	$400
HHFT device costs (adjusted)	$6109	$0	$6109
Consequent health care costs	$41,007	$51,455	-$10,448
Total Costs	$47,516	$51,455	-$3939

Figure 2 One-way sensitivity analysis – tornado chart.

Figure 3 Scatterplot of probabilistic sensitivity analysis.

Figure 4 Cost-effectiveness acceptability curve.

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