Temporal trends in healthcare resource use and associated costs of patients with cystic fibrosis |
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| Affiliation: | 1. RESearch on HealthcAre PErformance (RESHAPE), Claude Bernard Lyon 1 University, 8 Avenue Rockefeller, Lyon, F-69003.;2. Hospices Civils de Lyon, Lyon Sud Hospital, Cystic Fibrosis Center (CRCM), Department of Internal Medicine, 165 Chemin du Grand Revoyet, Pierre-Bénite, F-69495;3. PELyon, PharmacoEpidemiologie Lyon, 210 Avenue Jean Jaurès, Lyon, F-69007;4. Vaincre la Mucoviscidose Association, 181 Rue de Tolbiac, Paris, F-75013;5. Hospices Civils de Lyon, Health Data Department, 162 Avenue Lacassagne, Lyon, F-69003;6. Hospices Civils de Lyon, Croix-Rousse University Hospital, Department of Respiratory Medicine, 103 Grande Rue de la Croix-Rousse, Lyon, F-69002;1. National Heart & Lung Institute, Imperial College London, UK;2. Royal Brompton and Harefield Hospitals, London, UK;3. Department of Infectious Diseases, Imperial College London, UK;4. Department of Medicine, Queen''s University Belfast, UK;1. Department of Pediatrics, Division Pulmonology CB#7217 University of North Carolina, Chapel Hill, NC 27599-7217, United States;2. Marsico Lung Institute, 130 Mason Farm Rd. CB #7020 UNC-CH Chapel Hill NC 27599-7020. United States;3. Department of Biostatistics, University of North Carolina, 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC 27599-7400, United States;4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;5. Center for Disease Dynamics, Economics & Policy, Washington, DC;6. Department of Pediatrics, Columbia University Irving Medical Center, New York, 622 W 168th St, New York, NY 10032, United States;7. Department of Infection Prevention & Control, NewYork-Presbyterian Hospital, New York, 622 W 168th St, New York, NY 10032, United States;1. Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom;2. National Heart and Lung Institute, Imperial College London, Manresa Rd, London, United Kingdom;3. European Cystic Fibrosis Society Lung Clearance Index Core Facility, London, United Kingdom;4. Department of Respiratory Medicine, The Children''s Hospital at Westmead, Sydney, Australia;5. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia;1. School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, Co. Londonderry, Northern Ireland, BT52 1SA, UK,;2. Northern Ireland Regional Adult Cystic Fibrosis Centre, Level 8, Belfast City Hospital, Lisburn Road, Belfast, Northern Ireland, BT9 7AB, UK,;3. Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Belfast City Hospital, Lisburn Road, Belfast, Northern Ireland, BT9 7AD, UK.;1. Respiratory Division, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium;2. Department of Medicine, University of California, San Diego, CA 92093-0623, USA;1. Department of Pediatrics, University of Washington, Seattle, WA 98195, USA;2. Children''s Core for Biostatistics, Epidemiology and Analytics in Research, Seattle Children''s Research Institute, Seattle, WA 98101, USA;3. Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD 21287, USA;4. Division of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;5. Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA 98195, USA;6. Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;7. Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;8. Bioinformatics Research Center and Department of Statistics, North Carolina State University, Raleigh, NC 27695, USA;9. Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA;10. Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA;11. Division of Genetic Medicine, Seattle Children''s Hospital, Seattle, WA 98105, USA |
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| Abstract: | BackgroundBetter insights into the natural course of cystic fibrosis (CF) have led to treatment approaches that have improved pulmonary health and increased the life expectancy of affected individuals. This study evaluated how the combination of modified demographics and changes in CF management impacted resource consumption and the cost of care.MethodsMedical records of CF patients from 2006 to 2016 in the French CF Registry were linked to their corresponding claims data (SNDS). Medications, medical visits, procedures, hospitalisations, and indirect costs were annualized by calendar year from 2006 to 2017.ResultsOf the 7,671 patients included in the French CF Registry, 6,187 patients (80.7%) were linked to the SNDS (51.9% male, mean age = 24.7 years). The average cost per patient was €14,174 in 2006, €21,920 in 2011 and €44,585 in 2017. Costs associated with hospital stays increased from €3,843 per patient in 2006 to €6,741 in 2017. In 2017, the mean cost per CF patient was allocated as follows: 72% for medications (of which 51% for modulator therapies), 15% for hospital stays, 7% for medical visits, 3% for indirect costs, 2% for medical devices, 1% for outpatient medical procedures.ConclusionThere was a strong increase in the mean annual cost per CF patient between 2006 and 2017, mostly due to the cost of therapy after the introduction of cystic fibrosis transmembrane conductance regulator (CFTR) modulators. The combination of an increase in the number of CF patients – particularly adult patients – and an increase in the annual cost per patient led to a substantial increase in the total cost of CF disease care for the health systems. |
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