Cost-Utility Analysis of Supervised Inspiratory Muscle Training Added to Post-COVID Rehabilitation Program in the Public Health System of Brazil.

Objectives: This study aims to provide model-based cost-utility estimates for the addition of inspiratory muscle training (IMT) in COVID-19 pulmonary rehabilitation (PR).

Methods: A cohort model comparing IMT with PR (intervention group) to IMT with only PR (control group) was used. The payer perspective from the Unified Health System in Brazil was adopted. Effectiveness parameters: Effectiveness was measured in quality-adjusted life years (QALYs). Probabilistic sensitivity analyses were performed using 1000 Monte Carlo simulations. A beta probability distribution was assumed for utilities, and a gamma distribution was applied to the costs. A cost-effectiveness threshold of BRL 40.000/QALYs was applied.

Results: As the threshold of BRL 40.000/QALYs, we obtained 512 (51.2%) simulations that can be considered cost-effective to IMT added in PR programs. IMT added in PR treatment was more expensive (USD 317.73 versus USD 293.93) and more effective (incremental utility of 0.03 to INT group) than PR alone. The incremental cost-effectiveness ratio (ICER) was 793.93 USD/QALY.

Conclusions: IMT added to PR is a cost-effective alternative compared with PR for post-COVID-19 patients. This strategy may result in net cost savings and improvements in the QALYs for these patients.