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A health-economic analysis of diagnosis and treatment of obstructive sleep apnea with continuous positive airway pressure in relation to cardiovascular disease. The Greek experience.

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Abstract

Purpose

Obstructive sleep apnea syndrome (OSAS) is common in adult population and it is associated with increased morbidity and mortality, especially due to cardiovascular disease (CVD). Both diagnosis, based on polysomnography, and treatment with continuous positive airway pressure (CPAP), carry a potentially high cost. The present study aims to analyze the cost-effectiveness of CPAP treatment versus no treatment, in the long-term, as it examines the effect of this treatment on the incidence of CVD.

Methods

A Markov model was constructed to observe the disease evolution in patients with OSAS based on published evidence. Data on treatment costs were collected from public hospitals in Greece. Within each cycle of the model, each patient may remain free of CVD, may develop CVD, may die due to a cause related to CVD, or may die from other causes. The model begins at the age of 55 years in a severe OSAS patient (apnea-hypopnea index ≥30/h) and lasts for 45 years.

Results

Within the limitation of the model, CPAP was found to be a cost-effective strategy versus no treatment, due to the reduction of the cost for the CVD treatment, when the analysis was restricted to the male population. Moreover, CPAP was found to be clinically more effective than no treatment, as it increases life expectancy in both males and females.

Conclusions

CPAP was found to be clinically more effective therapy than no treatment in relation to CVD and a cost-effective strategy in males with severe OSAS.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Clinical Therapeutics, Division of Pulmonology, Medical School, National University of Athens, Athens, Greece

    Georgia Trakada

  2. Sleep Unit, Department of Psychiatry, Medical School, National University of Athens, Athens, Greece

    Georgia Trakada & Nicholas-Tiberio Economou

  3. Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece

    Evangelia Nena

  4. Department of Digital Systems Postgraduate Programme, Technology Education & Digital Systems, University of Piraeus, Piraeus, Greece

    Athanasia Trakada

  5. Department of Interventional Pneumonology, Ruhrlandklinik, West German Lung Center, University Duisburg-Essen, Essen, Germany

    Pavlos Zarogoulidis

  6. Department of Pneumonology, Medical School, Democritus University of Thrace, 68100, Alexandroupolis, Greece

    Paschalis Steiropoulos

Authors
  1. Georgia Trakada
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  2. Nicholas-Tiberio Economou
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  3. Evangelia Nena
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  4. Athanasia Trakada
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  5. Pavlos Zarogoulidis
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  6. Paschalis Steiropoulos
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Correspondence to Paschalis Steiropoulos.

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Trakada, G., Economou, NT., Nena, E. et al. A health-economic analysis of diagnosis and treatment of obstructive sleep apnea with continuous positive airway pressure in relation to cardiovascular disease. The Greek experience.. Sleep Breath 19, 467–472 (2015). https://doi.org/10.1007/s11325-014-1050-5

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  • DOI: https://doi.org/10.1007/s11325-014-1050-5

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