A new study compares the costs for two obstructive sleep apnea therapies: CPAP and Oral Appliance Therapy.
Even as oral appliance therapy (OAT) gains traction among sleep specialists as a viable alternative to CPAP for patients with mild to moderate obstructive sleep apnea (OSA), cost concerns remain a roadblock to adoption for many patients and clinicians.
Part of this is because, like so much in medicine, pricing isn’t transparent. Total costs of OSA treatment with both CPAP and OAT can vary based on the exact devices used as well as by payor, provider, and region. Out-of-pocket costs also vary wildly based on the exact details of patients’ insurance benefits. All of this makes it difficult to do an apples-to-apples cost comparison.
A cost analysis of these two OSA treatment options presented at the 2021 Virtual Annual Meeting of the American Academy of Dental Sleep Medicine attempts a true head-to-head cost comparison. This analysis, based on Medicare fee schedules, suggests that CPAP may be cheaper initially but that OAT comes with fewer costs over time.1
“We had never seen anyone do the math on how much the full cost of three to five years of PAP [positive airway pressure] therapy would be,” says study author Len Liptak, MBA, co-founder and CEO of oral appliance maker ProSomnus Sleep Technologies. “We hypothesized that after we added up the mask, hoses, humidifiers, filters, and other recurrent costs, PAP would be more than OAT.”
The analysis calculated an average daily reimbursement rate for CPAP and OAT by dividing the reimbursement fees for these items by the replacement interval duration based on the Medicare fee schedule or publicly available warranty durations. Calculations used simple averages to account for differences in reimbursement rates by regions and other variations in costs within the fee schedule.
