Abstract
Introduction
Advances in cystic fibrosis (CF) therapy have resulted in improved survival and increasing treatment burden and costs. The economic impact of current treatment strategies for CF is poorly defined.
Methods
The authors prospectively assessed direct medical costs (including hospitalizations, outpatient interventions, drugs, devices, dietetic products) in 165 consecutive CF patients (aged 5–39 years) seen between March and July 2009.
Results
The mean annual cost/patient increased with age and lung disease severity from yy4,164 in children aged ≤5 years to yy30,123 in patients aged >5 years with severe lung disease (forced expiratory volume in 1 second [FEV1] <40% of predicted). The increase in costs involved all items, with a progressive increase in cost attributed to hospitalizations.
Conclusion
Treatment of CF is associated with relevant cost for the Italian National Healthcare Service. Costs of illness tend to increase progressively with age, suggesting that increasing economic resources should be allocated to the treatment of CF, given the increasing number of patients surviving into adulthood.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Krauth C, Jalilvand N, Welte T, et al. Cystic fibrosis cost of illness and considerations for the economic evaluation of potential therapies. Pharmacoeconomics. 2003;21:1001–1024.
Farrell PM. The prevalence of cystic fibrosis in the European Union. J Cyst Fibros. 2008;7:450–453.
Bossi A. Report 2004 del Registro Italiano Fibrosi Cistica [in Italian]. Orizzonti FC. 2006;2:4–28.
Flume PA, Van Devanter DR. State of progress in treating cystic fibrosis respiratory disease. BMC Med. 2012;10:88.
Drumm ML, Ziady AG, Davis PB. Genetic variation and clinical heterogeneity in cystic fibrosis. Annu Rev Pathol. 2012;7:267–282.
Davis PB. Cystic fibrosis since 1938. Am J Respir Crit Care Med. 2006;173:475–482.
Davis PB. Cystic fibrosis since 1938. Am J Respir Crit Care Med. 2006;173:475–482.
Cohen-Cymberknoh M, Shoseyov D, Kerem E. Managing cystic fibrosis: strategies that increase life expectancy and improve quality of life. Am J Respir Crit Care Med. 2011;183:1463–1471.
Flume PA. Chronic cystic fibrosis respiratory infections: where do we go from here? Respir Med. 2011;105(Suppl. 2):S1.
Patient Registry Annual Data Report 2010. Bethesda, Maryland, USA. Cystic Fibrosis Foundation website. Available at: http://www.cff.org/UploadedFiles/LivingWithCF/CareCenterNetwork/PatientRegistry/2010-Patient-Registry-Report.pdf. Accessed Oct 31 2012.
Mogayzel PJ Jr, Flume PA. Update in cystic fibrosis 2010. Am J Respir Crit Care Med. 2011;183:1620–1624.
Sawicki GS, Tiddens H. Managing treatment complexity in cystic fibrosis: challenges and opportunities. Pediatr Pulmonol. 2012;47:523–533.
Pauly MV. The economics of cystic fibrosis. In: Lloyd-Still JD, editor. Textbook of cystic fibrosis. Boston: John Wright PSG Inc., 1983:465–476.
Robson M, Abbott J, Webb K, et al. A cost description of an adult cystic fibrosis unit and cost analyses of different categories of patients. Thorax. 1992;47:684–689.
US Congress Office of Technology Assessment. Cystic fibrosis and DNA tests: implications of carrier screening. Washington US Government Printing Office, 1992. Available at: http://www.fas.org/ota/reports/9208.pdf. Accessed Oct 31 2012.
Wildhagen MF, Verheij JB, Verzijl JG, et al. Cost of care of patients with cystic fibrosis in The Netherlands in 1990–1. Thorax. 1996;51:298–301. Erratum in: Thorax 1997; 52: 204.
Johnson JA, Connolly M, Jacobs P, et al. Cost of care for individuals with cystic fibrosis in Alberta: a regression approach to determining important cost drivers [working paper 99-2] Edmonton (AB): Institute of Health Economics. 1996:1–29.
Ireys HT, Anderson GF, Shaffer TJ, Neff JM. Expenditures for care of children with chronic illnesses enrolled in the Washington State Medicaid program, fiscal year 1993. Pediatrics. 1997;100:197–204.
Johnson JA, Connolly MA, Jacobs P, Montgomery M, Brown NE, Zuberbuhler P. Cost of care for individuals with cystic fibrosis: a regression approach to determining the impact of recombinant human DNase. Pharmacotherapy. 1999;19:1159–1166.
Lieu TA, Ray GT, Farmer G, et al. The cost of medical care for patients with cystic fibrosis in a health maintenance organization. Pediatrics. 1999;103:e72.
Wildhagen MF, Verheij JB, Verzijl JG, et al. The nonhospital costs of care of patients with CF in the Netherlands: results of a questionnaire. Eur Respir J. 1996;9:2215–2219.
Briesacher BA, Quittner AL, Fouayzi H, Zhang J, Swensen A. Nationwide trends in the medical care costs of privately insured patients with cystic fibrosis (CF), 2001–2007. Pediatr Pulmonol. 2011;46:770–776.
Koopmanschap MA. Cost-of-illness studies. Useful for health policy? Pharmacoeconomics. 1998;14:143–148.
Liou TG, Adler FR, Fitzsimmons SC, Cahill BC, Hibbs JR, Marshall BC. Predictive 5-year survivorship model of cystic fibrosis. Am J Epidemiol. 2001;153:345–352.
Buzzetti R, Alicandro G, Minicucci L, et al. Validation of a predictive survival model in Italian patients with cystic fibrosis. J Cyst Fibros. 2012;11:24–29.
Legge 548/93 “Disposizioni per la prevenzione e la cura della Fibrosi Cistica” [GU 30/12/1993, no 305]. Available at: http://www.medicoeleggi.com. Accessed Oct 3 31 2012.
Horvais V, Touzet S, Francois S, et al. Cost of home and hospital care for patients with cystic fibrosis followed up in two reference medical centres in France. International Journal of Technology Assessment in Health Care. 2006;22:525–531.
Padman R, McColley SA, Miller DP, et al. Infant care patterns at epidemiologic study of cystic fibrosis sites that achieve superior childhood lung function. Pediatrics. 2007;119:e531–537.
Eidt-Koch D, Wagner TO, Mittendorf T, Graf von der Schulenburg JM. Outpatient medication costs of patients with cystic fibrosis in Germany. Appl Health Econ Health Policy. 2010;8:111–118.
Dewitt EM, Grussemeyer CA, Friedman JY, et al. Resource use, costs, and utility estimates for patients with cystic fibrosis with mild impairment in lung function: analysis of data collected alongside a 48-week multicentre clinical trial. Value Health. 2012;15:277–283.
Ratjen F, Grasemann H. New therapies in cystic fibrosis. Curr Pharm Des. 2012;18:614–627.
Bush A, Simmonds NJ. Hot off the breath: ‘I’ve a cost for’ — the 64 million dollar question. Thorax. 2012;67:382–384.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is published with open access at Springerlink.com
Rights and permissions
Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
About this article
Cite this article
Colombo, C., Daccò, V., Alicandro, G. et al. Cost of Cystic Fibrosis: Analysis of Treatment Costs in a Specialized Center in Northern Italy. Adv Therapy 30, 165–175 (2013). https://doi.org/10.1007/s12325-013-0008-5
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12325-013-0008-5