{
  "abstract": "Objective In addition to the already positive outcomes of initiating home mechanical ventilation (HMV) at home, we aimed to explore the economic impact of implementation of initiating HMV at home versus traditional clinical settings, focusing on the Dutch healthcare system.Methods An Excel-based cost calculator model was used adhering to International Society of Pharmacoeconomics and Outcomes Research (ISPOR) budget impact analysis guidelines and based on the estimated population of HMV patients from 2023 to 2027 in the Netherlands. We compared home initiation of HMV against inpatient initiation in two scenarios based on patient eligibility and assessed financial impact from both health payer and societal perspectives.Results Substantial cost savings in both scenarios were observed, with significant reductions in hospital admission days and in waiting time among patients who initiated treatment at home. The main scenario (55% of patients initiated at home) indicated savings of €8.4 million for health payers and €10.0 million from a societal perspective over 5 years. The high-uptake scenario (85% of patients initiated at home) showed even greater savings: €13.8 million for health payers and €16.4 million from a societal perspective over 5 years. Tornado diagrams highlighted the low risk of unsuccessful implementation and potential for greater benefits than projected.Conclusion Initiating HMV at home yields substantial budget savings for payers and society in the Netherlands without compromising previously demonstrated clinical outcomes. These findings support broader implementation of home-based HMV initiation and may inform reimbursement reform and wider adoption of home-based HMV initiation.",
  "authors": [
    {
      "affiliations": [
        "Department of Pulmonary Diseases/Department of Intensive Care Medicine and Home Mechanical Ventilation, Erasmus Medical Center, Rotterdam, The Netherlands"
      ],
      "name": "Ries van den Biggelaar"
    },
    {
      "affiliations": [
        "Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Centre Groningen, Groningen, Groningen, The Netherlands"
      ],
      "name": "Marieke Duiverman"
    },
    {
      "affiliations": [
        "Department of Home Mechanical Ventialtion, University Medical Center Groningen, Groningen, The Netherlands"
      ],
      "name": "Anda Hazenberg"
    },
    {
      "affiliations": [
        "Department of General Practice & Elderly Care Medicine, Groningen Research Institute for Asthma & COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"
      ],
      "name": "J F. M van Boven"
    },
    {
      "affiliations": [
        "Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands"
      ],
      "name": "Karin Vermeulen"
    },
    {
      "affiliations": [
        "Pulmonary Diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands"
      ],
      "name": "Peter J Wijkstra"
    }
  ],
  "title": "Economic impact of initiation of home mechanical ventilation: a budget impact analysis from the Netherlands",
  "uid": "4e1d2b02-79ff-59a5-a5cf-137c4b4c427e"
}