The following is a summary of “Association Between Positive Airway Pressure Adherence and Health Care Costs Among Individuals With OSA,” published in the June 2023 issue of the Chest by An, et al.
Uncertainty surrounds the effect of positive airway pressure (PAP) therapy for OSA on healthcare costs. Are three-year health care costs associated with PAP adherence among Tele-OSA clinical trial participants? In the Tele-OSA study, participants with OSA who were prescribed PAP were stratified into three PAP adherence groups based on their utilization patterns over 3 years: high (consistently ≥4 h/night), moderate (2-3.9 h/night or inconsistently ≥4 h/night), and low (<2 h/night). Using data from 3 months of the Tele-OSA trial and 33 months of posttrial follow-up, the average healthcare costs in 6-month intervals (2020 US dollars) were derived from electronic health records and analyzed using multivariable generalized linear models.
About 25% of 543 participants were classified as having high PAP therapy adherence, 22% as having a moderate commitment, and 52% as having low PAP therapy adherence. The tall, middle, and low adherence groups utilized the PAP for an average of 6.5 ±1.0 h, ±3.7 ±1.2 h, and 0.5 ±0.5 h, respectively. The group with the highest adherence had the lowest average covariate-adjusted 6-month health care costs SE ($3,207 ±$251) compared to the groups with moderate and low commitment ($3,638± $363 and $4,010 ±$301, respectively).
Significant cost differences were observed between groups with high and low adherence ($832; 95% CI, $127 to $1,538), whereas differences between groups with moderate and low adherence were not significant ($401; 95% CI, -$441 to $1,243). Greater PAP adherence was associated with substantially lower healthcare costs over three years among participants with OSA. The findings support the significance of strategies to improve PAP adherence over the long term.