000K utf8 1100 2019$c2019-03-28 1500 eng 2050 urn:nbn:de:hbz:464-20220217-143648-5 2051 10.1159/000497101 3000 Pietzsch, Jan Benjamin 3010 Biermann-Stallwitz, Janine 3010 Geisler, Benjamin P. 3010 Liu, Shan 3010 Randerath, Winfried 3010 Richter, Ann-Kathrin 3010 Steffen, Armin 3010 Wasem, Jürgen 4000 Clinical and Economic Benefits of Upper Airway Stimulation for Obstructive Sleep Apnea in a European Setting [Pietzsch, Jan Benjamin] 4209 Background: Upper airway stimulation (UAS) is a treatment approach for patients with moderate-to-severe obstructive sleep apnea who cannot adhere to continuous positive airway pressure therapy. Objective: The objective was to evaluate added patient benefit and cost-effectiveness of UAS in the German health care system. Methods: We used a decision-analytic Markov model to project major adverse cardiovascular or cerebrovascular events (myocardial infarction [MI] or stroke), motor vehicle collision (MVC), mortality, quality-adjusted life years (QALYs), and costs. The assumed reduction in the apnea-hypopnea index with UAS compared to no treatment is based on German real-world data. Other input data were derived from the literature, public statistics, and multivariate regression. Cost-effectiveness was evaluated in Euros per QALY gained, both discounted at 3%. Results: UAS was projected to reduce event risks (10-year relative risk for stroke, MI, cardiovascular death, and MVC: 0.76, 0.64, 0.65, and 0.34, respectively), and to increase survival by 1.27 years. While the UAS strategy incurred an additional 1.02 QALYs within the patient lifetime, there were also additional costs of EUR 45,196, resulting in an incremental cost-effectiveness ratio of EUR 44,446 per QALY gained. Conclusions: In the present model-based analysis, UAS therapy provides meaningful benefit to patient-relevant endpoints and is a cost-effective therapy in the German setting. 4950 https://doi.org/10.1159/000497101$xR$3Volltext$534 4950 https://nbn-resolving.org/urn:nbn:de:hbz:464-20220217-143648-5$xR$3Volltext$534 4961 https://duepublico2.uni-due.de/receive/duepublico_mods_00072255 5051 610 5550 Cost-benefit analysis 5550 Cost-effectiveness analysis 5550 Decision support techniques 5550 Implantable pulse generator 5550 Markov model 5550 Obstructive sleep apnea 5550 Sleep apnea 5550 Upper airway stimulation