A SYSTEMATIC LITERATURE REVIEW ON ECONOMIC EVIDENCE FOR CONTINUOUS POSITIVE AIRWAY PRESSURE ADHERENCE IN OBSTRUCTIVE SLEEP APNEA
Author(s)
Melike Deger, MSc1, Raju Gautam, PhD2, Anoushka Pathak, MSc3, Ratna Pandey, MSc3, Fatima Sert, PhD4, Kate Cole, MSc4, Ankit Ghildiyal, MSc5.
1ResMed Science Center, Munich, Germany, 2ConnectHEOR, London, United Kingdom, 3ConnectHEOR, Delhi, India, 4ResMed Science Center, San Diego, CA, USA, 5ResMed Science Center, Didcot, Oxforshire, United Kingdom.
1ResMed Science Center, Munich, Germany, 2ConnectHEOR, London, United Kingdom, 3ConnectHEOR, Delhi, India, 4ResMed Science Center, San Diego, CA, USA, 5ResMed Science Center, Didcot, Oxforshire, United Kingdom.
OBJECTIVES: Research suggests that patient adherence to continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea (OSA) is associated with improved clinical outcomes and economic benefits. We aimed to summarize the economic evidence for adherent and non-adherent groups to CPAP therapy.
METHODS: A systematic literature review was conducted to identify studies reporting economic evidence with CPAP therapy in OSA. Searches were conducted in Embase®, MEDLINE®, and PubMed for literature published January-2005 through October-2025. Articles published in English as full-texts, conference abstracts, and HTA reports were included.
RESULTS: Of the 1,422 records identified through searches, 75 studies with economic evidence for CPAP were included. Of these, 28 studies focused on economic outcomes for CPAP-adherent and non-adherent groups. Most studies (20/28) were from the US. These studies were economic model-based evaluations (5), trial-based economic assessments (4) and prospective/retrospective observational studies on costs and healthcare resource use (HCRU; 19). Adherence to CPAP (18-studies) was usually defined as ≥4 hours of CPAP usage/night. Outcomes across costs and HCRU studies consistently reported that HCRU (including all-cause hospitalizations and emergency room visits; 20-studies) and total healthcare costs (18-studies) were significantly lower among CPAP-adherent groups versus CPAP-non-adherent at 6-months (~$646), 12-months (up to $4,487), and 2-years ($745). Results also indicated that annual cost benefits were particularly noticeable in OSA patients with comorbidities (HFpEF, $2,878; CVD, $2,290). A trend of reduction in ICER/QALY (up to $271/QALY) was observed when CPAP compliance increased (10% to 100%).
CONCLUSIONS: This review of economic evidence on CPAP therapy in OSA suggests that CPAP-adherence is associated with lower HCRU and costs compared with low-adherence. These findings highlight the potential value of interventions that improve CPAP-adherence and may help reduce the economic burden associated with OSA. Nevertheless, considering the heterogeneity across study designs and healthcare settings, these findings should be interpreted cautiously.
METHODS: A systematic literature review was conducted to identify studies reporting economic evidence with CPAP therapy in OSA. Searches were conducted in Embase®, MEDLINE®, and PubMed for literature published January-2005 through October-2025. Articles published in English as full-texts, conference abstracts, and HTA reports were included.
RESULTS: Of the 1,422 records identified through searches, 75 studies with economic evidence for CPAP were included. Of these, 28 studies focused on economic outcomes for CPAP-adherent and non-adherent groups. Most studies (20/28) were from the US. These studies were economic model-based evaluations (5), trial-based economic assessments (4) and prospective/retrospective observational studies on costs and healthcare resource use (HCRU; 19). Adherence to CPAP (18-studies) was usually defined as ≥4 hours of CPAP usage/night. Outcomes across costs and HCRU studies consistently reported that HCRU (including all-cause hospitalizations and emergency room visits; 20-studies) and total healthcare costs (18-studies) were significantly lower among CPAP-adherent groups versus CPAP-non-adherent at 6-months (~$646), 12-months (up to $4,487), and 2-years ($745). Results also indicated that annual cost benefits were particularly noticeable in OSA patients with comorbidities (HFpEF, $2,878; CVD, $2,290). A trend of reduction in ICER/QALY (up to $271/QALY) was observed when CPAP compliance increased (10% to 100%).
CONCLUSIONS: This review of economic evidence on CPAP therapy in OSA suggests that CPAP-adherence is associated with lower HCRU and costs compared with low-adherence. These findings highlight the potential value of interventions that improve CPAP-adherence and may help reduce the economic burden associated with OSA. Nevertheless, considering the heterogeneity across study designs and healthcare settings, these findings should be interpreted cautiously.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE349
Topic
Economic Evaluation, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies