Healthcare Resource Utilization and Cost After TCRF Treatment of Nasal Airway Obstruction: A Real-World Longitudinal Claims Analysis

Clinical Question

Does temperature-controlled radiofrequency (TCRF) treatment for nasal valve collapse (NVC)-related nasal airway obstruction (NAO) reduce healthcare utilization and overall costs compared with medical management?

Bottom Line

TCRF treatment is associated with significant reductions in healthcare resource utilization and overall costs over 24 months, in contrast to increasing costs and utilization with medical management alone.

Background: NAO, often due to nasal valve collapse, significantly affects quality of life and is associated with sleep disturbance and impaired daily functioning. While TCRF has demonstrated clinical efficacy, its real-world impact on healthcare utilization and costs remains less well characterized.

Study Design: Retrospective longitudinal claims analysis using a large U.S. database. Patients undergoing isolated TCRF were compared with propensity-matched medically managed (MM) patients. Outcomes were assessed over 24-month pre- and post-index periods.

Setting: Nationwide U.S. administrative claims database (Komodo Healthcare Map)

Synopsis: The study included 10,206 TCRF-treated patients and 50,766 medically managed controls, with similar baseline demographics and comorbidity profiles. TCRF patients demonstrated significant reductions in multiple categories of healthcare utilization after treatment. Office visits decreased by approximately 31%, emergency department visits by 26.5%, and telemedicine encounters by 39.2%. Additionally, ENT-related procedural utilization declined substantially, including nasal endoscopy (−42.9%), septoplasty (−62.8%), and turbinate procedures (−64.7%), reflecting reduced need for further interventions.

Medication utilization also declined following TCRF. Nasal corticosteroid use decreased by 23.9%, and antihistamine use declined by 26.6%, with nearly half of patients requiring no further nasal-related medication fills post-treatment. Sleep-related healthcare utilization—including sleep studies, medications, and obstructive sleep apnea procedures—also decreased significantly, suggesting broader systemic benefits.

Cost analysis demonstrated a marked divergence between groups. Mean daily post-index costs in the TCRF cohort decreased from $68.07 to $38.75 (−43.1%), whereas costs in the MM cohort increased from $42.08 to $63.26 (+50.4%) over the same period. This translated to a 24-month cost reduction of approximately $21,418 per patient in the TCRF group, compared with a cost increase of approximately $15,472 in the MM cohort. These savings were primarily driven by reductions in NAO-related healthcare utilization.

Limitations include reliance on claims data, exclusion of concurrent procedures such as septoplasty or sinus surgery within the index period, and lack of patient-reported outcomes. Nevertheless, the large sample size and real-world design enhance generalizability.

Citation: Kennedy DW, et al. Healthcare resource utilization and cost after temperature-controlled radiofrequency treatment of nasal airway obstruction: a real-world longitudinal claims analysis. Int Forum Allergy Rhinol. 2026;16:261-271. doi:10.1002/alr.70066.

Comment: TCRF nasal valve remodeling is a relatively new intervention to address the contribution of nasal valve collapse to nasal obstruction. The economic case for these interventions has been an area of question, with many payers refusing coverage despite the clinical efficacy demonstrated in trials. This study evaluated healthcare resource utilization and costs in patients treated with TCRF valve remodeling versus propensity-matched medically managed patients. Significant reductions in healthcare utilization and costs were noted at least two years after intervention. These findings may help establish the case for baseline coverage and/or appeals for denials going forward, allowing patients access to this intervention.—Ashoke Khanwalkar, MD