Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Economic Evaluation of Long-term Oxygen Therapy: 24 hours versus 15 hours per Day in Severe Hypoxemia: the REDOX Trial

Ssegonja, Richard ; Sundh, Josefin ; Andersson, Anders ; Björklund, Filip LU orcid ; Blomberg, Anders ; Currow, David ; Janson, Christer ; Lindberg, Eva ; Palm, Andreas and Ekström, Magnus LU orcid (2026) In Annals of the American Thoracic Society
Abstract
Background
Long-term oxygen therapy (LTOT) given for at least 15 hours/day improves survival in patients with severe chronic hypoxemia. However, the recent REDOX trial showed that LTOT prescribed for 24 hours/day was not superior to 15 hours/day in terms of death, hospitalizations, or self-reported outcomes. We aimed to examine the cost effectiveness of prescribing LTOT for 24 versus 15 hours/day.

Methods
A cost minimization analysis of the REDOX trial data on 241 patients with severe hypoxemic respiratory failure randomized 1:1 to either LTOT 24 hours/day (n = 117) or 15 hours/day (n = 124) and followed up to 12 months. Data on medical care consumption including prescribed medication costs, specialized outpatient and... (More)
Background
Long-term oxygen therapy (LTOT) given for at least 15 hours/day improves survival in patients with severe chronic hypoxemia. However, the recent REDOX trial showed that LTOT prescribed for 24 hours/day was not superior to 15 hours/day in terms of death, hospitalizations, or self-reported outcomes. We aimed to examine the cost effectiveness of prescribing LTOT for 24 versus 15 hours/day.

Methods
A cost minimization analysis of the REDOX trial data on 241 patients with severe hypoxemic respiratory failure randomized 1:1 to either LTOT 24 hours/day (n = 117) or 15 hours/day (n = 124) and followed up to 12 months. Data on medical care consumption including prescribed medication costs, specialized outpatient and inpatient care were retrieved from national registries. Mean differences in healthcare consumption costs (US$2024 prices) between groups were analyzed using generalized linear models. The cost analysis took a healthcare payer perspective and oxygen therapy costs are presented separately as out-of-pocket payments.

Results
During the 12 months of follow-up, patients prescribed LTOT for 24 hours/day had significantly lower mean costs for respiratory specific medications (US$-175; 95% CI, -329 to -29) but higher oxygen therapy costs (US$173; 80 to 268), compared to patients prescribed LTOT 15 hours/day. There were no significant differences between the groups in mean specialized outpatient and inpatient care costs, total medication costs, or in overall total costs (-US$4,951; -10,667 to 443) but numerically favouring usage of LTOT 24/day. A population level projection shows substantial potential cumulative cost savings of US$7.64 million if LTOT 24 h/day is adopted.

Conclusion
In addition to previously shown similar treatment efficacy, the overall healthcare costs did not significantly differ between LTOT prescribed 15 h/day and LTOT 24h/day. However, there is an observable numerical difference in favour of usage of LTOT 24 h/day. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Annals of the American Thoracic Society
publisher
American Thoracic Society
ISSN
2325-6621
DOI
10.1093/annalsats/aaoaf038
language
English
LU publication?
yes
id
3fb331dd-3af6-4312-966d-4b8400834863
date added to LUP
2026-02-08 13:56:11
date last changed
2026-02-09 07:34:26
@article{3fb331dd-3af6-4312-966d-4b8400834863,
  abstract     = {{Background<br/>Long-term oxygen therapy (LTOT) given for at least 15 hours/day improves survival in patients with severe chronic hypoxemia. However, the recent REDOX trial showed that LTOT prescribed for 24 hours/day was not superior to 15 hours/day in terms of death, hospitalizations, or self-reported outcomes. We aimed to examine the cost effectiveness of prescribing LTOT for 24 versus 15 hours/day.<br/><br/>Methods<br/>A cost minimization analysis of the REDOX trial data on 241 patients with severe hypoxemic respiratory failure randomized 1:1 to either LTOT 24 hours/day (n = 117) or 15 hours/day (n = 124) and followed up to 12 months. Data on medical care consumption including prescribed medication costs, specialized outpatient and inpatient care were retrieved from national registries. Mean differences in healthcare consumption costs (US$2024 prices) between groups were analyzed using generalized linear models. The cost analysis took a healthcare payer perspective and oxygen therapy costs are presented separately as out-of-pocket payments.<br/><br/>Results<br/>During the 12 months of follow-up, patients prescribed LTOT for 24 hours/day had significantly lower mean costs for respiratory specific medications (US$-175; 95% CI, -329 to -29) but higher oxygen therapy costs (US$173; 80 to 268), compared to patients prescribed LTOT 15 hours/day. There were no significant differences between the groups in mean specialized outpatient and inpatient care costs, total medication costs, or in overall total costs (-US$4,951; -10,667 to 443) but numerically favouring usage of LTOT 24/day. A population level projection shows substantial potential cumulative cost savings of US$7.64 million if LTOT 24 h/day is adopted.<br/><br/>Conclusion<br/>In addition to previously shown similar treatment efficacy, the overall healthcare costs did not significantly differ between LTOT prescribed 15 h/day and LTOT 24h/day. However, there is an observable numerical difference in favour of usage of LTOT 24 h/day.}},
  author       = {{Ssegonja, Richard and Sundh, Josefin and Andersson, Anders and Björklund, Filip and Blomberg, Anders and Currow, David and Janson, Christer and Lindberg, Eva and Palm, Andreas and Ekström, Magnus}},
  issn         = {{2325-6621}},
  language     = {{eng}},
  publisher    = {{American Thoracic Society}},
  series       = {{Annals of the American Thoracic Society}},
  title        = {{Economic Evaluation of Long-term Oxygen Therapy: 24 hours versus 15 hours per Day in Severe Hypoxemia: the REDOX Trial}},
  url          = {{http://dx.doi.org/10.1093/annalsats/aaoaf038}},
  doi          = {{10.1093/annalsats/aaoaf038}},
  year         = {{2026}},
}