ArticleCost effectiveness and resource allocation : C/E2025
Cost-effectiveness analysis of third-generation heat and moisture exchangers in patients who underwent laryngectomy in Japan.
Article in Cost effectiveness and resource allocation : C/E, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Provox Life HMEs for Pulmonary Rehabilitation in HME-Naïve Laryngectomy Patients: A Randomized Controlled Trial.Laryngoscope investigative otolaryngology · 2026Article
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundNational health insurance coverage for third-generation heat and moisture exchanger (HME) was approved in Japan for patients after total laryngectomy (TL). Our study evaluated the cost-effectiveness of third-generation HMEs (Provox® Life™ such as Provox® Life Night, Go, Home, Energy, and Protect) versus second-generation HMEs and no HME for patients who underwent TL in Japan.
methodsA Markov model with five health states was developed using an existing model from a Japanese public healthcare payer perspective, with a time horizon of 10 years and a cycle length of one year. Primary outcome was incremental cost-effectiveness ratio (ICERs), while secondary outcomes were pulmonary infection, mucus plug event and skin irritation. One-way sensitivity analyses (OWSA) and Probabilistic Sensitivity Analysis (PSA) were also conducted to determine the robustness of model conclusions.
resultsThird-generation HMEs resulted in an ICER of JPY 2,350,010 per QALY gained, at a willingness-to-pay threshold of JPY 5,000,000 per QALY gained, as compared to second-generation HMEs, indicating cost-effectiveness. Similarly, with an ICER of JPY 4,708,917 per QALY gained, third-generation HMEs were also more cost-effective than no HME. Third-generation HMEs showed a decrease in pulmonary infections (average amounts of pulmonary infections per patient over 10 years: 0.26 vs. 0.39 and 0.55), mucus plug event (0.29 vs. 0.47 and 2.14) and skin irritation (1.80 vs. 2.78 and 0.00) compared to second-generation HMEs and no HME. According to OWSA, the transition probabilities between health states were the main drivers for the cost difference between third-generation and second-generation HMEs. PSA confirmed the robustness of the findings.
conclusionThis is the first study to evaluate cost-effectiveness of HMEs in Japan, suggesting that third-generation HMEs (Provox® Life™) are more cost-effective compared to second-generation HMEs and no HME for patients who underwent TL in Japan.
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