Impact of Positive Airway Pressure (PAP) Therapy on Healthcare Costs in Obstructive Sleep Apnea (OSA): Analysis of a German Healthcare Database

Speaker(s)

Deger M1, Arzt M2, Ficker JH3, Sterling KL4, Vogelmann T5, Fietze I6, Young P7, Schoebel C8, Woehrle H9
1ResMed Science Center, Münich, BY, Germany, 2University Hospital Regensburg, Regensburg, Bayern, Germany, 3General Hospital Nuremberg and Paracelsus Medical University, Nuremberg, Bayern, Germany, 4ResMed Science Center, San Diego, CA, USA, 5LinkCare GmbH, Stuttgart, BW, Germany, 6Charité Universitätsmedizin Berlin, Berlin, Berlin, Germany, 7Medical Park, Bad Feilnbach, Bayern, Germany, 8University Hospital Duisburg-Essen, Essen, NW, Germany, 9Lung Center Ulm, Ulm, Bayern, Germany

Presentation Documents

OBJECTIVES: Worldwide, OSA affects nearly 1 billion adults and increases morbidity, mortality, and healthcare burden. Real-world data is needed to understand the impact of PAP therapy on healthcare resource utilization (HCRU). This study analyses HCRU and costs in patients with OSA from a German statutory health insurance database, offering critical insights for healthcare policymakers and providers.

METHODS: Patients with OSA were selected from an anonymised German health insurance claims database. Treatment-naïve patients were included if they had claims for PAP devices after a sleep apnoea evaluation (Polygraphy (PG) and Polysomnography (PSG)) and at least one claim for an OSA diagnosis without prior therapy. Control group patients were included if they were newly diagnosed OSA after polygraphy but had not received PAP. Propensity scores (PS) were estimated using known OSA risk factors, the most common comorbidities and medications, insurance status, region, and pre-index costs. We compared HCRU and costs between the two groups using 1:1 nearest neighbour matching based on estimated PS, age, and sex.

RESULTS: 8,768 PAP-treated and 8,768 matched controls were included. Over a 4-year follow-up, total mean costs per patient decreased in both groups from 5,818€ to 4,428€ (PAP) and 6,089€ to 4,186€ (non-PAP), with no significant cost difference between groups. Notably, in each year, PAP-treated patients had a lower proportion of inpatient healthcare costs vs non-PAP-treated patients: 33% vs 42% in year 1 and 35% vs 38% in year 4, respectively. Outpatient costs were slightly higher in the PAP-treated group. In year 1 of follow up, PG and PSG costs were observed between the PAP and non-PAP groups, respectively: 1% vs 4% PG, 5% vs 3% PSG.

CONCLUSIONS: PAP treatment in OSA patients did not increase overall costs per patient but inpatient costs were lower among PAP-treated patients, suggesting that PAP therapy may optimize healthcare resource allocation in secondary care.

Code

RWD145

Topic

Real World Data & Information Systems, Study Approaches

Topic Subcategory

Health & Insurance Records Systems

Disease

Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)