SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: In current clinical practice, High Frequency Chest Wall Oscillation (HFCWO) is prescribed for patients with moderate to severe Non-CF bronchiectasis. This study aimed to evaluate the clinical and economic outcomes of adult bronchiectasis patients with a high five-year morbidity and mortality risk, using HFCWO for airway clearance. METHODS: A Pre-Post study was conducted using the PharMetrics Health Plan Claims Database. Adult patients with bronchiectasis and a claim for HFCWO in 2009 to 2018 were included in the study. High risk status was determined by a Bronchiectasis Aetiology and Comorbidity Index (BACI) score of >6. All-cause and disease-specific healthcare care resource utilization and costs, as well as clinical outcomes, were measured at one and two-year follow-up periods, and compared to baseline. McNemar’s test was used for categorical variables, while Wilcoxon signed-rank test was used for continuous variables. RESULTS: Eighty patients met inclusion criteria. The mean age was 58 [13] years; 66.3% were female. Fifty-one percent of patients were diagnosed by a pulmonologist, who also prescribed 31.3% of devices. The proportion of all-cause oral antibiotic use reduced by 13% (P=0.03) in year two compared to baseline. IV antibiotic use trended down. All cause ER visits reduced by 37% in the second year compared to baseline (P=0.01). Laboratory use reduced by 5% in both years (P=0.05). Use of chest X-ray reduced by 21% in one-year follow-up(P=0.02) and 24% in year two (P=0.01). Bronchoscopy use reduced by 63% in one-year follow-up (P<0.01) and 68% in year two (P<0.001). There was a downward trend in all-cause hospitalizations in both years, compared to baseline. The proportion of disease specific physician office visits reduced by 13% (P=0.02) in one-year follow-up and 21% (P<0.01) in year two, compared to baseline. Laboratory use reduced by 33% in one-year follow-up (P=0.02) and 60% (P<.0001) in year two. Radiology use reduced by 43% in one-year follow-up (P<0.01) and 31% in year two (P<0.01). Bronchoscopy use reduced by 82% in one-year follow-up (P<0.01) and 91% in year two (P<0.01). Ancillary services use increased in year one by 19% (P<0.01) but reduced in year two by 17% (P=0.04). There was a trend towards reduced disease-specific hospitalizations in both the first and second year, compared to baseline. A trend towards reduced total all-cause costs in one-year and two-year follow-up was seen, compared to baseline. Disease-specific costs increased from a baseline of $4,811 to $11,633 in the first year (P<0.0001), likely due to device costs, then reduced significantly in the second year to $2,793 (P=0.04). CONCLUSIONS: In patients with bronchiectasis at high risk of morbidity and mortality, initiation of HFCWO therapy results in improvement in clinical and economic outcomes. CLINICAL IMPLICATIONS: Our findings lend support to the routine use of HFCWO in high risk bronchiectasis patients. DISCLOSURES: Advisory Board relationship with Insmed Please note: $1001 - $5000 by Ashwin Basavaraj, source=Web Response, value=Honoraria Consultant relationship with Hill-Rom Please note: $1001 - $5000 by Ashwin Basavaraj, source=Web Response, value=Consulting fee Employee relationship with Hill-Rom Company Inc. Please note: >$100000 Added 06/01/2020 by Brian Becker, source=Web Response, value=Salary Stock Ownership relationship with Hill-Rom Company Inc. Please note: $20001 - $100000 Added 06/01/2020 by Brian Becker, source=Web Response, value=Stock Ownership No relevant relationships by Mitch Dekoven, source=Web Response Employee relationship with Hillrom Please note: >$100000 Added 06/01/2020 by Angela Murray, source=Web Response, value=Salary No relevant relationships by Drishti Shah, source=Web Response Employee relationship with Hillrom Please note: >$100000 Added 06/01/2020 by Carlos Urrea, source=Web Response, value=Salary Employee relationship with Hill-Rom Inc Please note: >$100000 Added 05/31/2020 by Missy Wanjala, source=Web Response, value=Salary