Cost-Effectiveness Analysis of Uvulopalatopharyngoplasty Versus Positive Airway Pressure in Patient With Obstructive Sleep Apnea in South Korea

Background and Objectives Although positive airway pressure (PAP) is known to be more effective than uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea (OSA), PAP is a more expensive treatment in Korea. Therefore, it is necessary to compare the cost-effectiveness of these two treatments. Methods We assumed patients with moderate to severe OSA and divided them into three groups: those who used PAP (the PAP Treatment group), those who received UPPP (surgery group), and those who did not receive a diagnosis or treatment (No Treatment group). We compared their medical costs over 10 years. The incidence rate of common complications and accidents (coronary heart disease, heart failure, stroke, depression, diabetes, vehicle accident, and work-related accident) with or without treatment was adopted through a literature review. The average medical expenses for treating each complication and accident were also found by searching several databases. Results The incidence of all complications was higher in the control group than in the PAP Treatment group or the surgery group. However, since the absolute incidence rate was not high in all groups and medical expenses in Korea are low, the expected treatment cost was not high (KRW 108,209 per year for the PAP Treatment group, KRW 141,228 for the surgery group, and KRW 178,369 for the No Treatment group). In contrast, the costs of a polysomnography examination, PAP rental, and mask purchase were relatively high. Based on these results, the 10-year medical expenses for the PAP Treatment group were KRW 10,246,948, and those for the surgery were only KRW 925,095. Conclusion Although PAP treatment reduces the incidence of complications in OSA patients, it is not as cost-effective as UPPP in Korea, where medical costs are low.