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Non-invasive ventilation for COPD reduces costs and hospitalizations, study finds

A chief finding was that patients using NIV at home with a high-touch care model have the lowest overall costs and hospitalization rates.

Jeff Lagasse, Associate Editor

WHAT HAPPENED

Patients suffering from chronic obstructive pulmonary disease with chronic respiratory failure using home non-invasive ventilation live longer, are less likely to be admitted to a hospital and cost Medicare significantly less than patients using other devices.

Those are the recently released findings from a study of four years of Centers for Medicare and Medicaid Services data analyzed by KPMG, a global audit, tax and advisory firm, and VieMed, a provider of post-acute home respiratory services, which commissioned the report.

IMPACT

COPD is a chronic condition that affects as many as 24 million Americans and is the country's third-leading cause of death, after cancer and congestive heart failure.

Treating patients diagnosed with this progressive, chronic condition also costs the country more than $30 billion a year.

THE TREND

The study examined the costs and benefits of various respiratory assistive devices physicians commonly prescribe for patients suffering from COPD with CRF. A chief finding was that patients using NIV at home with a high-touch care model have the lowest overall costs and hospitalization rates.

A high-touch care model includes multiple home visits by a certified respiratory therapist, 24-hour access to medical professionals, and enhanced coordination with physicians and other clinicians.

Treating patients diagnosed with COPD costs the country more than $30 billion a year, the findings showed.

Specifically, the study examined results of untreated patients who used no respiratory device at home, patients using a bi-level positive airway pressure device, or BPAP, and patients using a NIV. The study looked at mortality, the number of times patients were hospitalized and the total cost of caring for patients in each group.

The analysis found that patients using a BPAP or NIV lived longer than untreated patients. For example, only 22 percent of COPD patients with CRF using NIV died, compared to 38 percent of untreated patients.

Although there was little difference in the overall death rates between patients using a BPAP or NIV, there were significant differences in the cost of treating these patients, as well as hospitalization rates.

For example, patients with no ventilation support cost CMS $41,000; patients using a BPAP cost $39,000; and those using NIV coupled with a high-touch care model cost $29,000.

Twenty-five percent of untreated patients were admitted to a hospital and 26 percent of patients using a BPAP were admitted, but fewer than 20 percent of patients using NIV and receiving high-touch care model were admitted.

Earlier this year Harvard Pilgrim Health Care signed an outcomes-based contract for Symbicort, AstraZeneca's drug to treat asthma and COPD. Harvard Pilgrim will be monitoring whether asthma-related symptoms for patients on Symbicort are in line with the clinical trial results provided by AstraZeneca.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com