Cost minimisation analysis of provision of oxygen at home: Are the Drug Tariff guidelines cost effective?

Objectives To determine the level of oxygen cylinder use at which it become s more cost effective to provide oxygen by concentrator at home in Northern Ireland, and to examine potential cost savings if cylinder use above this level had been replaced by concentrator in 1996. Design Cost minimisation analysis. Setting Area health boards in Northern Ireland. Main outcome measures Cost effective cut off point for switch to provision of oxygen from cylinder to concentrator. Potential maximum and minimum savi ngs in Northern Ireland (sensitivity analysis) owing to switch to more cost effective strategy on the basis of provision of cylinders in 1996. Results In Northern Ireland it is currently cost effective to provide oxyge n by concentrator when the patient is using three or more cylinders per mon th independent of the duration of the prescription. More widespread use of concentrators at this level of provision is likely to lead to a cost saving . Conclusions The Drug Tariff prescribing guidelines, advocating that provisi on of oxygen by concentrator becomes cheaper when 21 cylinders are being us ed per month-are currently inaccurate in Northern Ireland, Regional health authorities should review their current arrangements for provision of oxyge n at home and perform a cost analysis to determine at what level it becomes more cost effective to provide oxygen by concentrator.