Cost minimisation analysis of provision of oxygen at home: are the drug tariff guidelines cost effective?
OBJECTIVE
To determine the level of oxygen cylinder use at which it becomes more cost effective to provide oxygen by concentrator at home in Northern Ireland, and to examine potential cost savings if cylinder use above this level had been replaced by concentrator in 1996.


METHODS
Cost minimisation analysis.


METHODS
Area health boards in Northern Ireland.


METHODS
Cost effective cut off point for switch to provision of oxygen from cylinder to concentrator. Potential maximum and minimum savings in Northern Ireland (sensitivity analysis) owing to switch to more cost effective strategy on the basis of provision of cylinders in 1996.


RESULTS
In Northern Ireland it is currently cost effective to provide oxygen by concentrator when the patient is using three or more cylinders per month independent of the duration of the prescription. More widespread use of concentrators at this level of provision is likely to lead to a cost saving.


CONCLUSIONS
The Drug Tariff prescribing guidelines, advocating that provision of oxygen by concentrator becomes cheaper when 21 cylinders are being used per month-are currently inaccurate in Northern Ireland. Regional health authorities should review their current arrangements for provision of oxygen at home and perform a cost analysis to determine at what level it becomes more cost effective to provide oxygen by concentrator.
Heaney
L G
LG
Department of Respiratory Medicine, Belfast City Hospital, Belfast BT9 7AB. LiamHeaney@ukgateway.net
McAllister
D
D
MacMahon
J
J
D017046:Cost Savings; D003362:Cost-Benefit Analysis; D017408:Guidelines as Topic; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D000860:Hypoxia / Q000628:therapy*; D009660:Northern Ireland; D010102:Oxygen Inhalation Therapy / Q000191:economics* / Q000706:statistics & numerical data