A comparison of health-care costs in patients with chronic obstructive pulmonary disease using lightweight portable oxygen systems versus traditional compressed-oxygen systems.

BACKGROUND Lightweight portable oxygen systems are commonly preferred by patients over compressed-oxygen systems that use E-size cylinders. However, cost is often perceived as a barrier to the prescription of lightweight portable oxygen systems. OBJECTIVE To compare the overall health-care costs of patients with COPD who used lightweight portable oxygen systems to those who used E-cylinder systems. METHODS All the patients who used either a lightweight portable oxygen system, an E-cylinder system, or an E-cylinder system, then a lightweight portable oxygen system, for at least 12 months during the study period (January 1, 1999, to December 30, 2004) were identified from the administrative database of our regional managed-care system. All direct medical utilization and costs were captured for at least the first 12 months that supplemental oxygen was dispensed. Other clinical factors that affect costs (including age, sex, ethnicity, and comorbidities) were examined and adjusted for. RESULTS Of the 2,725 patients who met the inclusion criteria, 203 used only a lightweight portable oxygen system, 2,268 used only an E-cylinder system, and 254 switched from an E-cylinder system to a lightweight portable oxygen system. Among the patients who used only the lightweight portable oxygen system, the median total medical costs in the first year were nonsignificantly lower than those who used an E-cylinder system ($6,515/y vs $9,503/y). The cost difference remained nonsignificant after adjustment for clinical factors. Among the patients who switched from one system to the other in the first year, mean monthly health-care costs while using the lightweight portable oxygen system ($1,428) were not significantly different than when using the E-cylinder system ($1,396). CONCLUSIONS The type of oxygen system used did not significantly affect overall cost of care in patients with COPD on long-term oxygen therapy.