Dominic Coppolo

Cost-effectiveness of the Aerobika* oscillating positive expiratory pressure device in the management of COPD exacerbations

Introduction COPD places a huge clinical and economic burden on the US health care system, with acute exacerbations representing a key driver of direct medical costs. Current treatments, although effective in reducing symptoms and limiting exacerbations, do not adequately target the underlying disease processes that drive exacerbation development. The Aerobika* oscillating positive expiratory pressure (OPEP) device has been shown in a real-world effectiveness study to lower the frequency of moderate-to-severe exacerbations during a 30-day post-exacerbation period. This study sought to determine the impact on exacerbations and costs and to determine the cost-effectiveness of the Aerobika* device. Methods Data from published literature and national fee schedules were used to model the cost-effectiveness of the Aerobika* device in patients who had experienced an exacerbation in the previous month, or a post-exacerbation care population. Exacerbation trends and the impact of the Aerobika* device on reducing exacerbation frequency were modeled using a one-year Markov model with monthly cycles and three health states: (i) no exacerbation, (ii) exacerbation, and (iii) death. Scenario analysis and one-way sensitivity analysis (OWSA) were also performed. Results When the effect of Aerobika* device was assumed to last 30 days, use of the device resulted in cost-savings (

Under-Dosing of Inhaled Medication Delivered by Continuous Nebulizers Is Possible as the Result of Changes to Inspiratory/Expiratory (I/E) Ratio Brought About by Obstructive Lung Disease

553 per patient) and improved outcomes (ie, six fewer exacerbations per 100 patients per year) compared to no OPEP/positive expiratory pressure therapy. When the effect of the Aerobika* device was assumed to extend beyond the conservative 30-day time frame, the Aerobika* device remained the dominant strategy (21 fewer exacerbations per 100 patients per year; cost savings of

Self-Extubations: A 12-Month Experience

1,952 per patient). Consistency in findings after performing OWSAs indicates the robustness of results. Conclusion The Aerobika* device is a cost-effective treatment option that provides clinical benefit and results in direct medical cost savings in a post-exacerbation care COPD population.

Electrostatics and Inhaled Medications: Influence on Delivery Via Pressurized Metered-Dose Inhalers and Add-On Devices

CareFusion Misty FastTM continuous jet nebulizer Salter Labs NebuTech® HDN® continuous jet nebulizer RESULTS • Fine droplet mass (FDM<4.7μm, mean ± SD) values obtained as the product of TM and FDF<4.7μm are reported in the Table • FDM<4.7μm decreased with increasing I:E ratio for both nebulizer groups (1-way RMANOVA, p < 0.001) • The decline across the range studied taking I:E = 1:1 as reference (100-Δ FDF<4.7μm) was -42% for the Misty FastTM and -46% for the NebuTech® HDN® nebulizers respectively