Healthcare expenditures for privately insured US patients with cystic fibrosis, 2010‐2016

Abstract

Objectives: Published cost estimates for cystic fibrosis (CF) are based on older data and do not reflect increased use of specialty drugs in recent years. We assessed recent trends in healthcare expenditures for CF patients in the United States (US) with employer-sponsored health insurance. Methods: The study is a retrospective analysis of claims data for privately insured individuals aged 0–64 years who were continuously enrolled in non-capitated plans for at least 1 calendar year during 2010–2016. Mean annual expenditures during a calendar year were calculated for individuals who met a claims-based CF case definition. Average annual growth rates were calculated through linear regression of the natural logarithm of annual expenditures. Results: The annual CF prevalence was 1.1–1.4 per 10 000 adults and 2.9–3.0 per 10 000 children. Average spending adjusted for inflation nearly doubled from roughly $67 000 per patient in 2010 and 2011 to approximately $131 000 per patient in 2016. Inflation-adjusted spending on outpatient and inpatient care increased by 0.5% and 2.5% per year, respectively, whereas pharmaceutical spending increased by 20.2% per year. Virtually all of the growth in pharmaceutical spending was accounted for by spending on specialty drugs; inflation-adjusted spending on other medications increased by 1.3% per year. The annual growth rate in pharmaceutical spending rose by 33.1% during 2014–2016, the years during which lumacaftor/ivacaftor was introduced. Conclusions: Per-patient expenditures for privately-insured patients with CF almost doubled during 2010–2016; specialty drugs were largely responsible for this increase, with a major contribution from new, genotype-targeted CFTR modulator medications.

Cystic fibrosis carriers are at increased risk for a wide range of cystic fibrosis-related conditions

“…CF cohort. Subjects with CF were identified based on a CF diagnosis recorded during at least 1 inpatient stay or during 2 or more outpatient visits (46). Non-CF carrier matched-control cohorts.…”

Impact of pharmacy technicians as part of an integrated health‐system pharmacy team on improvement of medication access in the care of cystic fibrosis patients

“…Core members of the multidisciplinary CF care team include a physician, nurse, social worker, dietitian, respiratory therapist, and program coordinator. Medication complexity and medication costs have increased over the last few years, especially since the approval of CF transmembrane conductance regulator (CFTR) modulators 10 . To assist CF care teams with medication issues, the CFF added pharmacists as recommended members of the CF care team in 2015, which have been recognized as members of the multidisciplinary CF care teams for years in Europe, Australia, and the UK 11‐15 .…”

(R)-Roscovitine and CFTR modulators enhance killing of multi-drug resistant Burkholderia cenocepacia by cystic fibrosis macrophages

“…Of further concern is the growing incidence of multi-drug resistant bacterial strains isolated from CF respiratory samples 1 , 2 . While new medications such as cystic fibrosis transmembrane conductance regulator (CFTR) modulators are improving outcomes in CF, their high cost 3 , 4 prohibits widespread use in many countries and in those without (sufficient) insurance. Further, although infections are reduced on CFTR modulator treatment 5 , 6 , chronic infection remains a consistent feature 7 , indicating a continued need for novel approaches to the treatment of bacterial infections in CF.…”