{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:16:03Z","timestamp":1790691363289,"version":"4.1.0"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"1-2","license":[{"start":{"date-parts":[[2016,3,9]],"date-time":"2016-03-09T00:00:00Z","timestamp":1457481600000},"content-version":"unspecified","delay-in-days":68,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Technol Assess Health Care"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p><jats:bold>Objectives:<\/jats:bold> Untreated obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with excessive daytime sleepiness, increased risk of cardiovascular (CV) disease, and road traffic accidents (RTAs), which impact survival and health-related quality of life. This study, funded by the French National Authority for Health (HAS), aimed to assess the cost-effectiveness of different treatments (i.e., continuous positive airway pressure [CPAP], dental devices, lifestyle advice, and no treatment) in patients with mild-to-moderate OSAHS in France.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A Markov model was developed to simulate the progression of two cohorts, stratified by CV risk, over a lifetime horizon. Daytime sleepiness and RTAs were taken into account for all patients while CV events were only considered for patients with high CV risk.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> For patients with low CV risk, incremental cost-effectiveness ratio (ICER) of dental devices versus no treatment varied between 32,976 EUR (moderate OSAHS) and 45,579 EUR (mild OSAHS) per quality-adjusted life-year (QALY), and CPAP versus dental devices, above 256,000 EUR\/QALY. For patients with high CV risk, CPAP was associated with a gain of 0.62 QALY compared with no treatment, resulting in an ICER of 10,128 EUR\/QALY.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The analysis suggests that it is efficient to treat all OSAHS patients with high CV risk with CPAP and that dental devices are more efficient than CPAP for mild-to-moderate OSAHS with low CV risk. However, out-of-pocket costs are currently much higher for dental devices than for CPAP (i.e., 3,326 EUR versus 2,430 EUR) as orthodontic treatment is mainly non-refundable in France.<\/jats:p>","DOI":"10.1017\/s0266462316000088","type":"journal-article","created":{"date-parts":[[2016,3,9]],"date-time":"2016-03-09T09:50:36Z","timestamp":1457517036000},"page":"37-45","source":"Crossref","is-referenced-by-count":21,"title":["COST-EFFECTIVENESS OF TREATMENTS FOR MILD-TO-MODERATE OBSTRUCTIVE SLEEP APNEA IN FRANCE"],"prefix":"10.1017","volume":"32","author":[{"given":"Anne-Isabelle","family":"Poulli\u00e9","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magali","family":"Cognet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Gauthier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marine","family":"Clementz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Druais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Martin","family":"Sp\u00e4th","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lionel","family":"Perrier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Scemama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine Rumeau","family":"Pichon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Luc","family":"Harousseau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,3,9]]},"reference":[{"key":"S0266462316000088_ref020","first-page":"299","article-title":"ESPS-2 Working Group","volume":"239","year":"1992","journal-title":"J Neurol"},{"key":"S0266462316000088_ref010","volume-title":"La s\u00e9curit\u00e9 routi\u00e8re en France","year":"2011"},{"key":"S0266462316000088_ref013","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2005.00046.x"},{"key":"S0266462316000088_ref017","volume-title":"Cout annuel pour l'assurance maladie de la prise en charge des AVC en France en 2011 d'apr\u00e8s les donn\u00e9es du syst\u00e8me national d'information inter-r\u00e9gimes d'assurance maladie (SNIIRAM)","author":"Tuppin","year":"2013"},{"key":"S0266462316000088_ref008","volume-title":"Choices in methods for economic evaluation","author":"Haute Autorit\u00e9 de","year":"2012"},{"key":"S0266462316000088_ref005","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200611-1588OC"},{"key":"S0266462316000088_ref006","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-2-201201170-00006"},{"key":"S0266462316000088_ref016","volume-title":"L\u2019\u00e9valuation socio-\u00e9conomique des investissements publics","year":"2013"},{"key":"S0266462316000088_ref001","unstructured":"Haute Autorit\u00e9 de Sant\u00e9. Rapport SAHOS. Evaluation \u00e9conomique. September 2014. http:\/\/www.has-sante.fr\/portail\/upload\/docs\/application\/pdf\/2014-09\/rapport_sahos_-_evaluation_economique.pdf (accessed October 6, 2014)."},{"key":"S0266462316000088_ref002","first-page":"806","article-title":"Recommendations for clinical practice","volume":"27","year":"2010","journal-title":"Obstructive sleep apnea hypopnea syndrome in adults. Rev Mal Respir."},{"key":"S0266462316000088_ref015","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-009-0248-4"},{"key":"S0266462316000088_ref019","first-page":"762","article-title":"Effect of continuous positive airway pressure (CPAP) on blood pressure in patients with obstructive sleep apnea\/hypopnea","volume":"145","author":"Fava","year":"2014","journal-title":"A systematic review and meta-analysis. Chest."},{"key":"S0266462316000088_ref012","unstructured":"INSERM. Crude death rates per 100,000 population, France (mainland), 2010 http:\/\/www.cepidc.inserm.fr\/cgi-bin\/broker.exe (accessed September 2, 2013)."},{"key":"S0266462316000088_ref003","doi-asserted-by":"publisher","DOI":"10.3310\/hta13040"},{"key":"S0266462316000088_ref014","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-006-0002-9"},{"key":"S0266462316000088_ref009","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-013-0806-7"},{"key":"S0266462316000088_ref007","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462309090047"},{"key":"S0266462316000088_ref011","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2010.07.010"},{"key":"S0266462316000088_ref004","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)74229-X"},{"key":"S0266462316000088_ref018","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12140"}],"container-title":["International Journal of Technology Assessment in Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0266462316000088","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T23:40:43Z","timestamp":1555717243000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0266462316000088\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":20,"journal-issue":{"issue":"1-2","published-print":{"date-parts":[[2016]]}},"alternative-id":["S0266462316000088"],"URL":"https:\/\/doi.org\/10.1017\/s0266462316000088","relation":{},"ISSN":["0266-4623","1471-6348"],"issn-type":[{"value":"0266-4623","type":"print"},{"value":"1471-6348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016]]}}}