Cost-Effectiveness Of Treatments For Mild-To-Moderate Obstructive Sleep Apnea In France

Anne-Isabelle Poullié, Magali Cognet, Aline Gauthier, Marine Clementz, Sylvain Druais, Hans-Martin Späth, Lionel Perrier, Oliver Scemama, Catherine Rumeau Pichon and Jean-Luc Harousseau
Additional contact information
Anne-Isabelle Poullié: HAS - Haute Autorité de Santé [Saint-Denis La Plaine]
Magali Cognet: Amaris - Amaris - Amaris UK Ltd
Aline Gauthier: Amaris - Amaris - Amaris UK Ltd
Marine Clementz: Amaris - Amaris - Amaris UK Ltd
Sylvain Druais: Amaris - Amaris - Amaris UK Ltd
Hans-Martin Späth: UCBL - Université Claude Bernard Lyon 1 - Université de Lyon
Oliver Scemama: HAS - Haute Autorité de Santé [Saint-Denis La Plaine]
Catherine Rumeau Pichon: HAS - Haute Autorité de Santé [Saint-Denis La Plaine]
Jean-Luc Harousseau: HAS - Haute Autorité de Santé [Saint-Denis La Plaine]

Post-Print from HAL

Abstract: Objectives: Untreated obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with excessive daytime sleepiness, increased risk of cardiovascular (CV) disease, and road traffic accidents (RTAs), which impact survival and health-related quality of life. This study, funded by the French National Authority for Health (HAS), aimed to assess the cost-effectiveness of different treatments (i.e., continuous positive airway pressure [CPAP], dental devices, lifestyle advice, and no treatment) in patients with mild-to-moderate OSAHS in France. Methods: A Markov model was developed to simulate the progression of two cohorts, stratified by CV risk, over a lifetime horizon. Daytime sleepiness and RTAs were taken into account for all patients while CV events were only considered for patients with high CV risk. Results: For patients with low CV risk, incremental cost-effectiveness ratio (ICER) of dental devices versus no treatment varied between 32,976 EUR (moderate OSAHS) and 45,579 EUR (mild OSAHS) per quality-adjusted life-year (QALY), and CPAP versus dental devices, above 256,000 EUR/QALY. For patients with high CV risk, CPAP was associated with a gain of 0.62 QALY compared with no treatment, resulting in an ICER of 10,128 EUR/QALY. Conclusion: The analysis suggests that it is efficient to treat all OSAHS patients with high CV risk with CPAP and that dental devices are more efficient than CPAP for mild-to-moderate OSAHS with low CV risk. However, out-of-pocket costs are currently much higher for dental devices than for CPAP (i.e., 3,326 EUR versus 2,430 EUR) as orthodontic treatment is mainly non-refundable in France.

Keywords: Continuous positive airway pressure; Dental devices; Obstructive sleep apnea; Cost-effectiveness analysis (search for similar items in EconPapers)
Date: 2016
New Economics Papers: this item is included in nep-hea and nep-sog
Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-01327109v1
References: View complete reference list from CitEc
Citations:

Published in International Journal of Technology Assessment in Health Care, 2016, 32 (1), pp. 1-9. ⟨10.1017/S0266462316000088⟩

Downloads: (external link)
https://shs.hal.science/halshs-01327109v1/document (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:halshs-01327109

DOI: 10.1017/S0266462316000088

Access Statistics for this paper

More papers in Post-Print from HAL
Bibliographic data for series maintained by CCSD ().