Several articles have been written highlighting the use of airway clearance therapies such as High Frequency Chest Wall Oscillation (HFCWO) / High Frequency Chest Compression (HFCC) could potentially significantly reduce healthcare costs annually.


Currently in the United States, more than 23 million people have asthma. Approximately 13.6 million adults have been diagnosed with COPD, and an approximately equal number have not yet been diagnosed. The burden of respiratory diseases affects individuals and their families, schools, workplaces, neighborhoods, cities, and states. Because of the cost to the health care system, the burden of respiratory diseases also falls on society; it is paid for with higher health insurance rates, lost productivity, and tax dollars. Annual health care expenditures for asthma alone are estimated at $20.7 billion.


The following articles attempt to show the significant cost savings that can be made using HFCWO devices such as the RespIn 11 Bronchial Clearance System in home/clinical/hospital situations:


Chiappetta A, Mendendez A, Gozal D, Kiernan M. High-frequency chest wall oscillation in hospitalized non-cystic fibrosis patients. Am J Respir Crit Care Med 1996; 153:A566.

A retrospective medical chart review of 300 hospitalized non-cystic fibrosis patients (diagnoses unspecified) receiving professionally administered percussion and postural drainage (P&PD) treatments for secretion clearance found that a significant proportion of those costly treatments could have been effectively replaced with high frequency chest wall oscillation (HFCWO), thus providing a substantial savings in professional time, effort, and costs.


Klous DR, Boyle M, Hazelwood A, McComb RC. Chest vest & CF: Better care for patients. Adv Mgrs Respir Care 1993; 2(3):45-50.

This early report (1993) by respiratory care managers includes a six month cost/benefit of high frequency chest compression (HFCC)/high frequency chest wall oscillation (HFCWO) therapy in the in-patient setting. Using departmental quality assurance data, the mean number and session times of standard chest physiotherapy (CPT) were compared with the HFCC/HFCWO then being used for 55% of cystic fibrosis (CF) in-patients. Data analysis showed that by replacing 600 CPT treatments per month with HFCC/HFCWO, staff time savings of 236 hours would translate into a labor displacement of 2.85 full time equivalencies. (FTE). Advantages of HFCC/HFCWO included perceived effectiveness, patient satisfaction and increased ability of users to self-manage their CF.


Ohnsorg F. A cost analysis of high-frequency chest-wall oscillation in cystic fibrosis. Am J Respir Crit Care Med 1994; 149(4 pt.):A669.

BlueCross and BlueShield of Minnesota (BCBS/MN) conducted this retrospective record review of 23 cystic fibrosis (CF) clients to assess the impact of high frequency chest wall oscillation (HFCWO) therapy on total healthcare expenditures. Respiratory-illness related costs incurred during one year of HFCWO treatment, including the cost of the device itself, were compared with costs for the previous year. Data showed an aggregate reduction of 49% in total direct respiratory care costs during the year of HFCWO use.

 This analysis covered 446 neuromuscular disease patients that had received HFCWO therapy between 2007 and 2009 comparing health costs incurred before and after HFCWO therapy intervention.  The results of the study show lower claim costs for patients with neuromuscular disorders after the initial insurance claim for HFCWO

This report was prepared by Milliman on January 16, 2012