Gajdoš Ondřej, Rožánek Martin, Donin Gleb, Kamenský Vojtěch
Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, nám. Sítná 3105, 272 01 Kladno, Czech Republic.
Healthcare (Basel). 2021 Feb 1;9(2):142. doi: 10.3390/healthcare9020142.
Amyotrophic lateral sclerosis is a disease with rapid progression. The use of mechanical ventilation helps to manage symptoms and delays death. Use in a home environment could reduce costs and increase quality of life. The aim of this study is a cost-utility analysis of home mechanical ventilation in adult patients with amyotrophic lateral sclerosis from the perspective of healthcare payers in the Czech Republic. The study evaluates home mechanical ventilation (HMV) and mechanical ventilation (MV) in a healthcare facility. A Markov model was compiled for evaluation in a timeframe of 10 years. Model parameters were obtained from the literature and opinions of experts from companies dealing with home care and home mechanical ventilation. The cost-utility analysis was carried out at the end of the study and results are presented in incremental cost-utility ratio (ICUR) using quality-adjusted life-years. Uncertainty was assessed by one-way sensitivity analysis and scenario analysis. The cumulative costs of HMV are CZK 1,877,076 and the cumulative costs of the MV are CZK 7,386,629. The cumulative utilities of HMV are 12.57 quality-adjusted life year (QALY) and the cumulative utilities of MV are 11.32 QALY. The ICUR value is CZK-4,403,259. The results of this study suggest that HMV is cost effective.
肌萎缩侧索硬化症是一种进展迅速的疾病。使用机械通气有助于控制症状并延缓死亡。在家庭环境中使用可降低成本并提高生活质量。本研究的目的是从捷克共和国医疗保健支付方的角度，对成年肌萎缩侧索硬化症患者家庭机械通气进行成本效用分析。该研究评估了家庭机械通气（HMV）和医疗机构中的机械通气（MV）。编制了一个马尔可夫模型，用于在10年的时间范围内进行评估。模型参数来自文献以及从事家庭护理和家庭机械通气的公司专家的意见。在研究结束时进行了成本效用分析，并使用质量调整生命年以增量成本效用比（ICUR）呈现结果。通过单向敏感性分析和情景分析评估不确定性。家庭机械通气的累积成本为1,877,076捷克克朗，机械通气的累积成本为7,386,629捷克克朗。家庭机械通气的累积效用为12.57个质量调整生命年（QALY），机械通气的累积效用为11.32个QALY。ICUR值为-4,403,259捷克克朗。本研究结果表明家庭机械通气具有成本效益。
