Cost-effectiveness of NIV applied to chronic respiratory failure.(Chapter 26).

The expansion of HMV in the last 15 yrs was stimulated by the introduction of non-invasive mask ventilation and the recognition that more patient groups could benefit.In the management of health-care resources the costs-analysis currently represents a method to evaluate the expenditure due to the effects on health of a new (or specific) intervention and to assess it in the economic perspective. Disability-adjusted life years (DALYs), healthy year equivalents (HYEs), or quality-adjusted life years (QALYs) are all time-based measures of health that include the impact of interventions on years of life lost due to premature mortality and years of life lived with a non-fatal health outcome, weighted by the severity of that outcome.Despite effectiveness of non-invasive HMV has been addressed so far, the impact of this treatment on the overall costs is not clearly reported nor still demonstrated and very few data based on a true economic analysis in patients under non-invasive HMV are published. Direct and (partially) indirect cost calculation have been observed and reported especially in COPD patients under non-invasive HMV. The most recent data underlie the large impact of non-invasive HMV on both patients’ outcome (reduction of recurrent admissions and increase in quality of life) and families’ burden (unemployment, financial and social issues), thus prompting new studies with appropriate cost-effectiveness and/or cost-utility analysis.