title: Cost-effectiveness of Continuous Positive Airway Pressure Treatment in Moderate-Severe Obstructive Sleep Apnea Syndrome.
abstract: BACKGROUND
  The socioeconomic impact of obstructive sleep apnea-hypopnea syndrome (OSAHS) is considerable. The aim of this study was to evaluate the cost-effectiveness of treating OSAHS with continuous positive airway pressure (CPAP) and the impact of CPAP compliance.
  
  
  METHODS
  This was a retrospective, case-crossover study of 373 patients with OSAHS receiving CPAP. We compared changes in costs, Epworth score and health-related quality of life (EQ-5D questionnaires) between the year before treatment and the year after treatment. The incremental cost-effectiveness ratio (ICER) for the first year of treatment was estimated, and projections were made for the second year, using different effectiveness and cost scenarios.
  
  
  RESULTS
  The visual analog scale score for the EQ-5D questionnaire increased by 5 points and the Epworth score fell by 10 points during the year of CPAP treatment. Mean gain in quality-adjusted life years (QALY) was 0.05 per patient per year (P<.001): 0.07 among compliers and -0.04 among non-compliers. ICER was €51,147/QALY during the first year of CPAP treatment and €1,544/QALY during the second year.
  
  
  CONCLUSIONS
  CPAP treatment in patients with moderate-severe OSAHS improves the quality of life of compliant patients, and is cost-effective as of the second year.
authors.affiliation: Unidad del Sueño, Sección de Neumología, Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona, España. Electronic address: raqcatala@hotmail.com.
authors.forename: Raquel
authors.initials: R
authors.lastname: Català
authors.affiliation: Instituto Max Weber, Madrid, España.
authors.forename: Renata
authors.initials: R
authors.lastname: Villoro
authors.affiliation: Instituto Max Weber, Madrid, España.
authors.forename: María
authors.initials: M
authors.lastname: Merino
authors.affiliation: Unidad del Sueño, Sección de Neumología, Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona, España.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sangenís
authors.affiliation: Innovació i Docència, Grup SAGESSA-GINSA, Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona, España.
authors.forename: Lluís
authors.initials: L
authors.lastname: Colomés
authors.affiliation: Unidad del Sueño, Sección de Neumología, Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona, España.
authors.forename: Salvador
authors.initials: S
authors.lastname: Hernández Flix
authors.affiliation: Servicio de Neumología, Hospital Universitario Lucus Augusti, Lugo, España.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Pérez de Llano
mesh_terms: D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000191:economics; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D018592:Cross-Over Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017286:Polysomnography; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000191:economics / Q000628:therapy*; D013030:Spain
keywords: Análisis coste-efectividad; Apnea del sueño; Calidad de vida; Continuous positive airway pressure; Cost-effectiveness analysis; Presión positiva continua de vías aéreas; Quality of life; Sleep apnea