OBJECTIVES: Obstructive sleep apnea (OSA) is a common disorder characterized by repetitive episodes of airway obstruction during sleep, leading to significant health complications and economic burdens. Traditional care involves costly, resource-intensive in-lab polysomnography and follow-up visits. Virtual care models, that use telemedicine and innovative sensor technology, offer a promising alternative that may reduce healthcare costs while improving patient outcomes. This study explores the economic impact of virtual care for OSA management in the German statutory health system.

METHODS: A cost-consequence analysis was conducted to simulate and compare two clinical pathways: standard care (SoC) and virtual care (VC), the latter utilizing smartphone-based OSA screening and home polysomnography for diagnosis, followed by home therapy initiation if required. The impact on budget impact from the perspective of the statutory health insurance, and on care pathway times from the perspective of patients were evaluated.

RESULTS: Simulated outcomes for diagnostic assessment and treatment in the SoC arm were average costs of 728.71€ and care pathway times of 169 days. Outcomes with VC would reduce healthcare spending by 22.8% (-178.23€) per patient while shortening average care pathway times by 83.4% (-141 days). Effects were driven by greater diagnostic accuracy of the first-line test in the VC pathway, resulting in fewer patients requiring expensive and more comprehensive sleep assessment, as well as shorter waiting times for consultations.

CONCLUSIONS: Use of VC for patients with OSA has the potential to reduce care pathway times substantially while decreasing healthcare spending. Validation in clinical practice is required to substantiate the results of this simulation.