[Therapeutic switch from liquid oxygen to oxygen concentrators in the Turin City Local Health Authority: results of...

In patients with chronic respiratory failure and a stable oxygen requirement ≤4 L/min, switching from liquid oxygen to oxygen concentrators represents a potential strategy to optimize home oxygen therapy, although structured real-world experiences remain limited. This study describes the experience of the COMBO Project implemented by the Turin City Local Health Authority, aimed at the planned implementation of a therapeutic switch from liquid oxygen to oxygen concentrators and the assessment of its organizational and management outcomes. A retrospective descriptive-comparative observational study was conducted by comparing two periods (May-December 2023 and May-December 2024). A total of 129 patients eligible for the therapeutic switch were analyzed; for patients who completed the transition, a descriptive counterfactual scenario was developed to estimate the expected economic impact. The switch was successfully completed by 104 patients (80.6%). During the observation period, a 69% increase in the use of oxygen concentrators and a 3.9% reduction in liquid oxygen consumption were observed. Comparison with the counterfactual scenario showed an expected cost reduction of 2.56%. The main critical issues related to the transition process involved clinical, logistical, and prescribing aspects among patients who did not complete the switch. The COMBO Project experience demonstrates the feasibility of a structured therapeutic switch model in territorial healthcare settings; the value of the intervention lies primarily in process organization and in the coordinating role of the Territorial Pharmaceutical Service, while the observed economic impact should be interpreted as an expected benefit. The model appears potentially replicable in similar healthcare contexts.