Clinical and economic burden of idiopathic pulmonary fibrosis: a retrospective cohort study

Abstract

BackgroundIdiopathic pulmonary fibrosis (IPF) is a devastating condition with a variable course. Not uncommonly, IPF patients are hospitalized for respiratory-related causes, including disease worsening. This study aimed to characterize the prevalence, and economic and health care burden of IPF.MethodsRetrospective insurance claims data collected yearly between January 1, 2009 and December 31, 2011, were used to determine prevalence and calculate all-cause and respiratory-related resource utilization and costs. Patients had at least one inpatient claim or two outpatient claims for IPF (ICD-9-CM code 516.3). Results for health care burden are reported for the 2011 cohort (similar findings in 2009–2010). Costs are reported in 2011 US dollars ($).ResultsPatients with IPF had a mean age of 69.8–71.3 years. Overall prevalence for IPF was 28.8, 28.1 and 19.8 per 100,000 insured persons in 2009, 2010 and 2011. In each year, prevalence increased with age. In 2011, 37.7 % of patients were hospitalized at least once for any cause; 19.5 % for respiratory-related reasons. Also in 2011, the mean number of all-cause outpatient visits and respiratory-related office visits was 18.5 and 5.7 per patient, respectively. All-cause health care costs in 2011 were $59,379 per patient; 36.6 % of costs ($21,732) were respiratory related.ConclusionsThe prevalence of IPF in this claims database increased with age, with a notable increase in those over 65 years. IPF is associated with a large economic and health care burden. Additional research is needed to determine how such burden might be reduced.

Validation of the COPD Assessment Test (CAT) in patients with idiopathic pulmonary fibrosis

“…The cardinal symptoms are increased exertional dyspnoea and dry cough. Progression of fibrosis leads to respiratory insufficiency and death [1,7,9–11]. Disease progress is often slow and occurs gradually over a few years.…”

Influence of Idiopathic Pulmonary Fibrosis Progression on Healthcare Resource Use

“…The latter provide useful information on the relative cost burden of IPF from a US-payer perspective, and both studies agreed on a more than twofold increase in the annual rate of hospitalisation (post-index) [18,19,23]. Raimundo et al [20] estimated that respiratory events were responsible for half of the hospitalisations that occurred during the 3 years of observations for patients with IPF. Although it is difficult to compare with accuracy with the other studies, our findings point to the same direction with increased odds of hospitalisation after a 10-point reduction in FVC%pred during a 3-month interval.…”

“…Several recent studies suggested that IPF incurred a substantial economic and health burden [18][19][20][21][22][23]. The methods varied between studies from an Adelphi panel [22], database analyses of patients with IPF [20,21] and comparisons of IPF and non-IPF estimates [18,19,23].…”

“…The methods varied between studies from an Adelphi panel [22], database analyses of patients with IPF [20,21] and comparisons of IPF and non-IPF estimates [18,19,23]. The latter provide useful information on the relative cost burden of IPF from a US-payer perspective, and both studies agreed on a more than twofold increase in the annual rate of hospitalisation (post-index) [18,19,23].…”

[Nintedanib for the treatment of idiopathic pulmonary fibrosis in Italy]

“…I costi non sanitari possono raggiungere quasi il 90% della spesa totale per cause respiratorie [66]. I costi indiretti associati ad IPF assumono dimensioni ragguardevoli, poiché i pazienti con IPF sono tendenzialmente senza lavoro o raggiungono la pensione prima dei soggetti senza IPF della stessa età [67].…”