ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2013
Medicare long-term CPAP coverage policy: a cost-utility analysis.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Content Comparison of Quality-of-Life Instruments Used in Economic Evaluations of Sleep Disorder Interventions: A Systematic Review.PharmacoEconomics · 2024Pooled it
- A systematic review of the association between obstructive sleep apnea and ventricular arrhythmias.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2014Pooled it
- What's leak got to do with it? Association of mask leak and positive airway pressure adherence from the homepap study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Trial
- Trial
- The Global Socioeconomic Burden of Obstructive Sleep Apnea: A Comprehensive Review.Healthcare (Basel, Switzerland) · 2025Review
- [Home CPAP Remote Monitoring as a System to Control Adaptation and Titration in Obstructive Sleep Apnoea and its Impact on the Management of this Pathology (T-CPAP Project)].Open respiratory archives · 2024Article
- Effectiveness of Treating Obstructive Sleep Apnea by Surgeries and Continuous Positive Airway Pressure: Evaluation Using Objective Sleep Parameters and Patient-Reported Outcomes.Journal of clinical medicine · 2024Article
- Article
- International Consensus Statement on Obstructive Sleep Apnea.International forum of allergy & rhinology · 2023Review
- Coverage Decisions for Positive Airway Pressure Therapy: Intended and Unintended Consequences.Annals of the American Thoracic Society · 2023Article
- Obstructive sleep apnea screening, diagnosis, and treatment in the transportation industry.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Economic evaluation of CPAP therapy for obstructive sleep apnea: a scoping review and evidence map.Sleep & breathing = Schlaf & Atmung · 2022Article
- The Impact of National Health Insurance Coverage on Compliance With Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea.Clinical and experimental otorhinolaryngology · 2022Article
- Effects of Exercise in Patients with Obstructive Sleep Apnoea.Clocks & sleep · 2021Review
- The PAP-NAP one decade later: patient risk factors, indications, and clinically relevant emotional and motivational influences on PAP use.Sleep & breathing = Schlaf & Atmung · 2020Article
- Association between body mass index and effectiveness of continuous positive airway pressure in patients with obstructive sleep apnea: a retrospective study.Sleep & breathing = Schlaf & Atmung · 2020Article
- Effect of Positive Airway Pressure Therapy on Drowsy Driving in a Large Clinic-Based Obstructive Sleep Apnea Cohort.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019Article
- Association of Positive Airway Pressure Use With Acute Care Utilization and Costs.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019Article
- Cost-effectiveness strategies in OSAS management: a short review.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2017Review
- Impact of Sleep-Disordered Breathing Treatment on Quality of Life Measures in a Large Clinic-Based Cohort.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesCPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG.
designCost-utility and cost-effectiveness analysis.
settingU.S. Medicare Population. PATIENTS OR
participantsN/A.
interventionsN/A. MEASUREMENTS AND
resultsWe created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY.
conclusionsCurrent CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.