Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Jan 23;8(1):e018835.
doi: 10.1136/bmjopen-2017-018835.

Cost-effectiveness of FreeO2 in patients with chronic obstructive pulmonary disease hospitalised for acute exacerbations: analysis of a pilot study in Quebec

Thomas G Poder  1   2 , Christian R C Kouakou  2 , Pierre-Alexandre Bouchard  3 , Véronique Tremblay  4 , Sébastien Blais  4 , François Maltais  3 , François Lellouche  3
Affiliations
Randomized Controlled Trial

Cost-effectiveness of FreeO2 in patients with chronic obstructive pulmonary disease hospitalised for acute exacerbations: analysis of a pilot study in Quebec

Thomas G Poder et al. BMJ Open. .

Abstract

Objective: Conduct a cost-effectiveness analysis of FreeO2 technology versus manual oxygen-titration technology for patients with chronic obstructive pulmonary disease (COPD) hospitalised for acute exacerbations.

Setting: Tertiary acute care hospital in Quebec, Canada.

Participants: 47 patients with COPD hospitalised for acute exacerbations.

Intervention: An automated oxygen-titration and oxygen-weaning technology.

Methods and outcomes: The costs for hospitalisation and follow-up for 180 days were calculated using a microcosting approach and included the cost of FreeO2 technology. Incremental cost-effectiveness ratios (ICERs) were calculated using bootstrap resampling with 5000 replications. The main effect variable was the percentage of time spent at the target oxygen saturation (SpO2). The other two effect variables were the time spent in hyperoxia (target SpO2+5%) and in severe hypoxaemia (SpO2 <85%). The resamplings were based on data from a randomised controlled trial with 47 patients with COPD hospitalised for acute exacerbations.

Results: FreeO2 generated savings of 20.7% of the per-patient costs at 180 days (ie, -$C2959.71). This decrease is nevertheless not significant at the 95% threshold (P=0.13), but the effect variables all improved (P<0.001). The improvement in the time spent at the target SpO2 was 56.3%. The ICERs indicate that FreeO2 technology is more cost-effective than manual oxygen titration with a savings of -$C96.91 per percentage point of time spent at the target SpO2 (95% CI -301.26 to 116.96).

Conclusion: FreeO2 technology could significantly enhance the efficiency of the health system by reducing per-patient costs at 180 days. A study with a larger patient sample needs to be carried out to confirm these preliminary results.

Trial registration number: NCT01393015; Post-results.

Keywords: bootstrap; canada; copd; cost-effectiveness; freeo2; oxygen-titration.

PubMed Disclaimer

Conflict of interest statement

Competing interests: FL is the coinventor of the FreeO2 system and cofounder of Oxynov, the firm that developed and productionised the FreeO2 system for marketing. The Fonds de Recherche en Santé du Québec contributes to Dr François Lellouche salary for research activities (clinical research scholar) and to the research assistant’s salary (clinical research grant). FM holds a GlaxoSmithKline/Canadian Institutes of Health Research chair on COPD at Laval University. FM participates in Innovair, a company that owns shares in OxyNov, the owner of the FreeO2 device.

Figures

Figure 1
Figure 1
Joint distribution and incremental cost-effectiveness acceptability curve for time spent at the target SpO2 (multivariate parametric bootstrap). ICER, incremental cost-effectiveness ratio.
Figure 2
Figure 2
Joint distribution and incremental cost-effectiveness acceptability curve for time spent in hyperoxia (multivariate parametric bootstrap). ICER, incremental cost-effectiveness ratio.
Figure 3
Figure 3
Joint distribution and incremental cost-effectiveness acceptability curve for time spent in hypoxaemia (multivariate parametric bootstrap). ICER, incremental cost-effectiveness ratio.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization. Chronic obstructive pulmonary disease (COPD). 2016. http://www.who.int/respiratory/copd/en/ (accessed 23 Nov 2016).
    1. Khakban A, Sin DD, FitzGerald JM, et al. . The Projected Epidemic of COPD Hospitalizations Over the Next 15 Years: A Population Based Perspective. Am J Respir Crit Care Med 2016. 10.1164/rccm.201606-1162PP - DOI - PubMed
    1. Statistique Canada. Enquête sur la santé dans les collectivités canadiennes. 2010. http://www.cadretravailpulmonaire.ca/santerespiratoireauCanada/ (accessed 23 Nov 2016).
    1. Agence de la santé publique du Canada. Faits saillants sur la maladie pulmonaire obstructive chronique (MPOC). 2011. http://www.phac-aspc.gc.ca/cd-mc/publications/copd-mpoc/ff-rr-2011-fra.php (accessed 23 Nov 2016).
    1. Mittmann N, Kuramoto L, Seung SJ, et al. . The cost of moderate and severe COPD exacerbations to the Canadian healthcare system. Respir Med 2008;102:413–21. 10.1016/j.rmed.2007.10.010 - DOI - PubMed

Publication types

MeSH terms

Associated data