Cost Analysis of High-Flow Oxygen Therapy Compared with Conventional Oxygen Therapy in Severe COVID-19 in Colombia: Data from a Randomized Clinical Trial

Abstract

Sergio I Prada,1,2 Maria P Garcia-Garcia,1 Gustavo A Ospina-Tascón,3,4 Diego Rosselli5 1Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia; 2Universidad Icesi, Centro PROESA, Cali, Colombia; 3Department of Intensive Care, Fundación Valle del Lili, Cali, Colombia; 4Translational Medicine Laboratory in Critical Care (TransLab-CCM), Universidad Icesi, Cali, Colombia; 5Clinical Epidemiology and Biostatistics Department, Pontificia Universidad Javeriana, Bogota, ColombiaCorrespondence: Sergio I Prada, Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cra. 98 18-49, Cali, Valle, Colombia, Email [email protected]: A randomized clinical trial (HiFlo-COVID-19 Trial) showed that among patients with severe COVID-19, treatment with high-flow oxygen therapy (HFOT) significantly reduced the need for invasive mechanical ventilation support and time for clinical recovery compared with conventional oxygen therapy (COT). However, the cost of this strategy is unknown.Objective: We examined total cost of HFOT treatment compared with COT in real-world setting.Methods: We conducted a post-trial-based cost analysis from the perspective of a managed competition healthcare system, using actual records of billed costs. Cost categories include general ward, intensive care unit, procedures, imaging, laboratories, medications, supplies, and others.Results: A total of 188 participants (mean age 60, 33% female) were included. Average costs (and standard deviation) in the HFOT group were USD $7992 (7394) and in the COT group USD $ 10,190 (9402). Differences, however, did not reach statistical significance (P=0.093). However, resource use was always less costly for the HNFO group, with an overall percentage decrease of 27%. Two categories make up 72% of all savings: medications (41%) and intensive care unit (31%).Conclusion: For patients in ICU with severe COVID-19 the cost of treatment with HFOT as compared to COT is likely to be cost-saving due to less use of medications and length of stay in ICU.Keywords: SARS-CoV-2, COVID-19, cost analysis, economic evaluation, high-flow nasal oxygen, conventional oxygen therapy, high-flow oxygen therapy, clinical trial, cost, Colombia

Keywords

• sars-cov-2
• covid-19
• cost analysis
• economic evaluation
• high-flow nasal oxygen
• conventional oxygen therapy
• high-flow oxygen therapy
• clinical trial
• cost
• colombia.