Non-invasive ventilation (NIV) in a domiciliary setting may be cost-effective for post-hospitalized chronic obstructive pulmonary disease (COPD) patients, according to a study published in journal Thorax.

Researchers used a Markov model-based cost-utility analysis from the UK National Health Service perspective to compare the cost-effectiveness of domiciliary NIV with usual care for two end-stage COPD populations. One population had stable COPD commencing treatment with no recent hospital admission, and the other was a posthospital population starting treatment following admission for an exacerbation.

The study found that at the threshold of £20,000 per quality-adjusted life-year (QALY), domiciliary NIV is 99.9% likely cost-effective in a posthospital population, but unlikely to be cost-effective in stable populations. Cost-effectiveness estimates were sensitive to longer-term readmission and mortality risks, and duration of benefit from NIV, the researchers noted.

Domiciliary NIV is likely cost-effective for post-hospitalized patients, with uncertainty around the cost-effectiveness of domiciliary NIV in stable patients with COPD on which further research should focus,” the researchers concluded.

Keywords: COPD epidemiology, COPD exacerbations, non-invasive ventilation