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

Expert Rev Pharmacoecon Outcomes Res. 2023 Apr;23(4):399-407. doi: 10.1080/14737167.2023.2181792. Epub 2023 Mar 8.

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.

MeSH terms

  • Adult
  • Colombia
  • Continuous Positive Airway Pressure*
  • Cost-Benefit Analysis
  • Humans
  • Insurance, Health, Reimbursement
  • Sleep Apnea, Obstructive* / therapy