Supplemental oxygen costs and equipment utilization in a low-income population with ILD or COPD

RationaleSupplemental oxygen is often prescribed to patients with interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD). The specific costs of oxygen therapy in these diseases have not been fully described in patients living in the United States. ObjectivesEstimate Medicaid/Medicare costs for supplemental oxygen, characterize differences in oxygen equipment utilization, and identify factors impacting the costs of supplemental oxygen therapy in ILD and COPD. MethodsWe reviewed claims data for years 2016-2020 for Pennsylvania residents with ILD or COPD who were dually eligible for Medicaid/Medicare and enrolled in traditional fee-for-service Medicare. A generalized estimated equation (GEE) model was used to identify variables associated with annual oxygen costs. Measurements and Main ResultsA greater proportion of paid claims in ILD were for oxygen services (40.3% vs 22.0%) and for high flow oxygen (4.2% vs 2.2%), though ILD represented the minority of paid oxygen claims (5.2%). Oxygen cost approximately $65/month for both groups. Most oxygen claims ([≥]94%) were for stationary concentrators. Liquid devices and stationary gas were the least utilized equipment. Lower costs were associated with living in a competitive bidding area and with markers of advanced age and worse health status. ConclusionsOxygen utilization is greater in ILD but is only a small portion of total oxygen claims compared to COPD. Costs and equipment utilization were similar between groups. Liquid oxygen claims were rare even among subjects requiring high flow. Oxygen therapy is common in these diseases and likely represents a significant contribution to total healthcare costs.