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Randomized Controlled Trial
. 2022 Jan;21(1):61-69.
doi: 10.1016/j.jcf.2021.02.014. Epub 2021 Mar 12.

Health care costs related to home spirometry in the eICE randomized trial

Natalie Franz  1 , Hannah Rapp  1 , Ryan N Hansen  2 , Laura S Gold  3 , Christopher H Goss  4 , Noah Lechtzin  5 , Larry G Kessler  6
Affiliations
Randomized Controlled Trial

Health care costs related to home spirometry in the eICE randomized trial

Natalie Franz et al. J Cyst Fibros. 2022 Jan.

Abstract

Background: Home spirometry with regular symptom assessment is one strategy to track lung health to intervene early in episodes of pulmonary exacerbations (PE). In a multi-center randomized controlled trial home spirometry and symptom tracking demonstrated no significant differences regarding the primary clinical endpoint, FEV1, compared to usual care, but did identify differences in healthcare utilization. We used data from the Early Intervention in Cystic Fibrosis Exacerbation (eICE) study to evaluate whether home monitoring of PE is a cost-minimizing intervention in the context of this randomized trial.

Methods: We reviewed healthcare resource utilization of all 267 eICE participants, including outpatient visits, antibiotics and hospitalizations. Prices were identified in the IBM/Watson MarketScanⓇ Commercial Claims and Encounters Databases and averaged over the 2014-2017 period. Using total healthcare utilization costs, we generated summary statistics by intervention and protocol arm (total cost, mean cost, standard deviation). We performed Welch Two Sample t-tests to determine if total costs and cost by type of utilization differed significantly between groups.

Results: Outpatient visit costs were significantly higher by 13% in the Early Intervention (EI) than in the usual care (UC) arm ($3,345 vs. $2,966). We found no significant differences in outpatient antibiotic, hospitalization, or total health care costs between the arms.

Conclusions: Within the context of the eICE trial, outpatient visits were significantly higher in those with experimental home spirometry care, but that did not translate into statistically significant differences of overall health care costs between the two arms.

Keywords: Cystic fibrosis; Healthcare cost, Cost effectiveness; Home spirometry; Pulmonary exacerbations.

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Conflict of interest statement

Declaration of Competing Interest We have disclosed our involvement with the grants above that have funded this work. No conflict of interest exists related to any of the authors and the contents of this manuscript.

Comment in

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