Economic impact of initiation of home mechanical ventilation: a budget impact analysis from the Netherlands
Ries van den Biggelaar, Marieke Duiverman, Anda Hazenberg, J F. M van Boven, Karin Vermeulen, Peter J WijkstraObjective
In addition to the already positive outcomes of initiating home mechanical ventilation (HMV) at home, we aimed to explore the economic impact of implementation of initiating HMV at home versus traditional clinical settings, focusing on the Dutch healthcare system.
Methods
An Excel-based cost calculator model was used adhering to International Society of Pharmacoeconomics and Outcomes Research (ISPOR) budget impact analysis guidelines and based on the estimated population of HMV patients from 2023 to 2027 in the Netherlands. We compared home initiation of HMV against inpatient initiation in two scenarios based on patient eligibility and assessed financial impact from both health payer and societal perspectives.
Results
Substantial cost savings in both scenarios were observed, with significant reductions in hospital admission days and in waiting time among patients who initiated treatment at home. The main scenario (55% of patients initiated at home) indicated savings of €8.4 million for health payers and €10.0 million from a societal perspective over 5 years. The high-uptake scenario (85% of patients initiated at home) showed even greater savings: €13.8 million for health payers and €16.4 million from a societal perspective over 5 years. Tornado diagrams highlighted the low risk of unsuccessful implementation and potential for greater benefits than projected.
Conclusion
Initiating HMV at home yields substantial budget savings for payers and society in the Netherlands without compromising previously demonstrated clinical outcomes. These findings support broader implementation of home-based HMV initiation and may inform reimbursement reform and wider adoption of home-based HMV initiation.