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Rising costs of hypoglossal nerve stimulators

Hypoglossal nerve stimulators (HGNS), approved by the FDA in 2014, are second line agents to treat OSA among patients who do not tolerate CPAP. As Dr. Rathi and colleagues report in JAMA Otolaryngology, sales of HGNS are rising. Using publicly available data from the U.S. Securities and exchange commission, the authors found 4,459 units have been sold since 2015, with sales increasing more than 7 fold increase since 2015. Using standard Medicare fees and published per-unit costs, Rathi et al estimate placement of each HGNS costs $28,367, with $88.6 million spent on placing HGNS units overall since 2015. The authors note that despite these substantial expenditures, assessments of cost effectiveness are lacking. Matched with these costs, it will be important for us to understand the value in usual care for HGNS in terms of patients’ quality of life and health outcomes. (Post by: Luke Donovan)