High-flow nasal cannula for acute exacerbation of chronic obstructive pulmonary disease: a Cost-utility analysis

BackgroundHigh-flow nasal cannula (HFNC) is an alternative for delivering respiratory support to adults with acute exacerbations of chronic obstructive pulmonary disease. Despite increased popularity for respiratory support, there is still uncertainty about if their l costs of justify the clinical benefits provided. This study aims to evaluate the cost-utility of HFNC in acute exacerbations of chronic obstructive pulmonary disease in Colombia MethodsUsing a decision tree model, we estimated the cost and quality-adjusted life-years (QALYs) associated with HFNC and conventional oxygen therapy (COT) in adults who presented to the emergency department with acute exacerbations of chronic obstructive pulmonary disease. All parameters for the model were derived from published research with local data. All analyses were done from a societal perspective. ResultsWe estimate a gain of 0,49 and 0,48 QALYs per patient-year on HFNC and COT respectively, and a difference of US$314 in total discounted cost per person-year on HFNC respecting COT. Because HFNC was associated with lower costs compared to conventional therapy, the incremental cost effectiveness ratio was not calculated. ConclusionsHFNC achieving better outcomes at a lower cost in patients with acute exacerbations of chronic obstructive pulmonary disease in Colombia. Evidence should continue to be generated with real-life effectiveness data and economic evaluations in other countries to confirm our findings.