Title: Costs of Ventilation Options Derived from nThrive® Database – Retrospective Database Analysis

Abstract:

Statement of the Problem:

Noninvasive ventilation (NIV) is a recommended treatment for acute and chronic respiratory failure, especially in patients with chronic obstructive pulmonary disease (COPD) [1-4]. In comparison with invasive ventilation, NIV has the advantages of reducing the rate of intermittent mechanical ventilation (IMV), associated procedural complications (such as ventilator associated pneumonia), mortality and charges for ventilatory support [1, 5]. Identifying the predictors of NIV failure is important because of the strong link between failure and poor outcomes and because it may impact the cost of care. However, very little attention has been paid to the timing of the failure [4, 6-8]. Therefore, incorrect patient selection at admission, under-recognition of timing of NIV failure, or patient interface issues is subsequently associated with increased procedural complications and mortality as well as increased charges [5, 9]. The objective of this study was to estimate the frequency of use and compare NIV and IMV costs.

Methodology and Theoretical Orientation:

Hospitalized patients with COPD and respiratory distress treated with NIV or IMV were analyzed from the nThrive® US-database [10]. We included patients older than 18 years of age admitted with a primary diagnosis of COPD or a primary diagnosis of respiratory failure with a secondary diagnosis of COPD. Patients were grouped by their use of NIV and IMV: NIV only, IMV only, NIV prior to IMV and IMV prior to NIV. The following NIV ICD10 procedure codes were used: 5A09357, 5A09457, 5A09557. For IMV, ICD10 procedure codes were: 0BH17EZ and 0BH18EZ. We examined all patients in 2018 in the US. Total hospital costs were reported as means and standard deviation. All costs are in 2018 US dollars.

Biography:

Goran Medic is a Senior Manager for Health Economics and Outcomes Research (HEOR) in Philips. In this role, Goran drives the implementation and execution of health economic strategies and analyses for Philips’ products and services, both marketed and in development. He has over 14 years of global, regional (Europe, Middle East, Canada and US) and local hands-on experience in HEOR, market access and reimbursement. He is self-driven to develop HTA value propositions and data driven solutions to support decision making in access of innovative medical devices to patients. He is making strategic decisions on the launch sequence and HEOR evidence roadmaps of premium-priced medical devices. In his current and past roles, Goran has honed his expertise and skills in proactively identifying payer / HTA relevant evidence requirements to support relative value demonstration and product differentiation. Goran has more than 30 peer-reviewed scientific publications