HOT HMV Therapy

Philips shares the latest on HOT-HMV therapy

A Philips-sponsored study indicates that the combination of non-invasive ventilation (NIV) and home oxygen therapy (HOT) can significantly prolong time to readmission or death for patients with chronic obstructive pulmonary disease (COPD) and chronic hypercapnia following a life-threatening respiratory event or exacerbation. The five-year, multi-center study of 116 patient in the UK resulted in prolonged median time to readmission or death by nearly three months, and improved patient health-related quality of life in the first six weeks.

The results showed that the addition of home NIV to home oxygen therapy prolonged the median time to re-admission from 1.4 months to 4.3  months,demonstrating a breakthrough for COPD treatment.

The potential health economic impact within the US was previously unknown. However, the current study reports the incremental cost-effectiveness of HOT-HMV in patients with hypercapnic COPD.The original trial data were used to develop an economic model, and findings were featured at the 2018 ATS International Conference in an abstract poster presentation from the payer perspective for both the U.S. and the UK.

 

The base-case incremental cost/QALY (quality adjusted life year) gained was negative $50,856,suggesting HOT-HMV as a dominant strategy (less expensive and more effective). Costs for HOT-HMV patients were $4,298 for devices, $10,805 for doctor visits, $758 for medication and $8,598 for exacerbations. HOT alone had the following costs: $1,582 for devices, $15,033 for doctor visits, $1,088 for medication and $10,683 for exacerbations. 

 

In addition to the clinical effectiveness of HOT-HMV as previously reported, this data support cost effectiveness as well.

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ATS International Conference 2018 Abstract Poster

Cost-Effectiveness of Home Oxygen Therapy-Home Mechanical Ventilation (HOT-HMV) for Treatment of Chronic Obstructive Pulmonary Disease (COPD) with Chronic Hypercapnic Respiratory Failure Following an Acute Exacerbation of COPD in the United States (US)
Cost-Effectiveness of Home Oxygen Therapy-Home Mechanical Ventilation (HOT-HMV) for the Treatment of Chronic Obstructive Pulmonary Disease (COPD) with Chronic Hypercapnic Respiratory Failure Following an Acute Exacerbation of COPD in the United Kingdom (UK)

Murphy PB, et al. Effect of Home Noninvasive Ventilation With Oxygen Therapy vs Oxygen Therapy Alone on Hospital Readmission or Death After an Acute COPD Exacerbation A Randomized Clinical Trial. JAMA. Published online May 21, 2017. doi:10.1001/jama.2017.4451

2 Criner, G. et al, Cost Effectiveness of Home Oxygen Therapy-Home Mechanical Ventilation (HOT-HMV) for Treatment of Chronic Obstructive Pulmonary Disease (COPD) with Chronic Hypercapnic Respiratory Failure Following an Acute Exacerbation of COPD in the United States (US), American Thoracic Society Abstract 2018