Cost-effectiveness of NIV applied to chronic respiratory failure.Eur

The expansion of home mechanical ventilation (HMV) in the last 15 yrs was stimulated by the introduction of noninvasive mask ventilation and the recognition that more patient groups could benefit.In the management of healthcare resources, cost-analysis currently represents a method for evaluation of the expenditure due to the effects on health of a new (or specific) intervention and for assessing it in the economic perspective. Disabilityadjustedlife-yrs, healthy-yr equivalents and quality-adjusted life-yrs are all time-based measures of health that include the impact of interventions on years of life lost due to premature mortality and years of life lived with a nonfatal health outcome, weightedby the severity of that outcome.Although the effectiveness of noninvasive HMV has been addressed, the impact of this treatment on the overall costs has not been clearly reported or demonstrated and very few data based on a true economic analysis in patients under noninvasive HMV have been published. Direct and (partially) indirect cost calculations have been observed and reported, especially in chronic obstructive pulmonary disease patients under noninvasive HMV. The most recent data underline the large impact ofnoninvasive HMV on both patient outcome (reduction of recurrent admissions and increase in quality of life) and family burden (unemployment, financial and social issues), thus prompting further studies with appropriate cost-effectiveness and/or cost-utility analysis.