Cost drivers in the pharmacological treatment of interstitial lung disease.

Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 101090633 Publication Model: Electronic Cited Medium: Internet ISSN: 1465-993X (Electronic) Linking ISSN: 14659921 NLM ISO Abbreviation: Respir Res Subsets: MEDLINE

Publication: 2001- : London : BioMed Central Ltd.
Original Publication: London : Current Science Ltd., c2000-

Drug Costs/*trends ; Lung Diseases, Interstitial/*drug therapy ; Lung Diseases, Interstitial/*economics; Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Follow-Up Studies ; Germany/epidemiology ; Humans ; Longitudinal Studies ; Lung Diseases, Interstitial/epidemiology ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies

Introduction: Treatments of interstitial lung diseases (ILDs) mainly focus on disease stabilization and relief of symptoms by managing inflammation or suppressing fibrosis by (in part costly) drugs. To highlight economic burden of drug treatment in different ILD-subtypes we assessed cost trends and therewith-associated drivers.
Methods: Using data from the German, observational HILDA study we estimated adjusted mean medication costs over 36-month intervals using one- and two-part Generalized Estimating Equation (GEE) regression models with a gamma distribution and log link. Next, we determined factors associated with costs.
Results: In Idiopathic pulmonary fibrosis (IPF) mean per capita medication costs increased from €1442 before to €11,000€ at the end of study. In non-IPF subtypes, the increase took place at much lower level. Mean per capita ILD-specific medication costs at the end of the study ranged between €487 (other ILD) and €9142 (IPF). At baseline, higher FVC %predicted values were associated with lower medication costs in IPF (-9%) and sarcoidosis (-1%). During follow up higher comorbidity burden escalated costs in progressive fibrosing ILD (PF-ILD) (+52%), sarcoidosis (+60%) and other ILDs (+24%). The effect of disease duration was not uniform, with cost savings in PF-ILD (-8%) and sarcoidosis (-6%), but increased spending in IPF (+11%).
Conclusion: Pharmacological management of ILD, in particular of IPF imposes a substantial economic burden on the healthcare system. Strategies to reduce comorbidity burden and early treatment may reduce the impact of ILDs on the healthcare system.
(© 2021. The Author(s).)

Eur Respir Rev. 2015 Sep;24(137):428-35. (PMID: 26324804)
Ann Am Thorac Soc. 2016 Aug;13(8):1244-52. (PMID: 27509154)
Pathologe. 2019 Dec;40(Suppl 3):363-365. (PMID: 31712888)
Chest. 2014 Apr;145(4):723-728. (PMID: 24114524)
Eur Respir Rev. 2018 Dec 21;27(150):. (PMID: 30578337)
Eur Respir Rev. 2019 Sep 4;28(153):. (PMID: 31484664)
Respir Res. 2017 Jul 14;18(1):139. (PMID: 28709421)
J Clin Med. 2018 Nov 24;7(12):. (PMID: 30477216)
J Health Econ. 2004 May;23(3):525-42. (PMID: 15120469)
Respir Med. 2016 Apr;113:74-9. (PMID: 26915984)
PLoS One. 2016 Mar 29;11(3):e0151425. (PMID: 27023440)
Am J Respir Crit Care Med. 2020 Aug 1;202(3):e36-e69. (PMID: 32706311)
N Engl J Med. 2014 May 29;370(22):2083-92. (PMID: 24836312)
Annu Rev Public Health. 2007;28:95-111. (PMID: 17112339)
Lung. 2017 Feb;195(1):1-8. (PMID: 27866277)
Eur Respir Rev. 2017 Jan 3;26(143):. (PMID: 28049126)
Biometrics. 1982 Dec;38(4):963-74. (PMID: 7168798)
Sarcoidosis Vasc Diffuse Lung Dis. 2020;36(3):228-242. (PMID: 32476958)
BMC Pulm Med. 2016 Jan 12;16:7. (PMID: 26758510)
Intern Emerg Med. 2018 Apr;13(3):325-331. (PMID: 29299831)
Am J Respir Crit Care Med. 2011 Feb 15;183(4):431-40. (PMID: 20935110)
Curr Opin Pulm Med. 2013 Sep;19(5):453-9. (PMID: 23872860)
Lancet Respir Med. 2020 Sep;8(9):925-934. (PMID: 32890499)
BMC Med. 2015 Sep 25;13:245. (PMID: 26407727)
J Investig Allergol Clin Immunol. 2015;25(4):237-50; quiz follow 250. (PMID: 26310038)
Respir Med. 2019 Jun;152:25-31. (PMID: 31128606)
Respir Res. 2018 May 25;19(1):101. (PMID: 29801506)
Lancet Respir Med. 2020 May;8(5):453-460. (PMID: 32145830)
Eur Respir J. 2018 May 17;51(5):. (PMID: 29773608)
Respir Med. 2019 Jun;152:7-13. (PMID: 31128613)
Dtsch Med Wochenschr. 2018 Dec;143(24):1774-1777. (PMID: 30508858)
Adv Ther. 2020 Jul;37(7):3292-3298. (PMID: 32451950)
Respir Res. 2019 Mar 14;20(1):57. (PMID: 30871560)
Health Qual Life Outcomes. 2020 Oct 8;18(1):334. (PMID: 33032602)
J Heart Lung Transplant. 2016 Oct;35(10):1227-1236. (PMID: 27377220)
Open Respir Med J. 2012;6:63-74. (PMID: 22896776)
J Med Econ. 2012;15(5):829-35. (PMID: 22455577)
Respir Res. 2020 Jan 29;21(1):32. (PMID: 31996266)

Keywords: Diffuse parenchymal lung disease; Direct costs; Healthcare expenditure; Healthcare spending; ILD management

Date Created: 20210804 Date Completed: 20220107 Latest Revision: 20240403

20240403

PMC8335870

10.1186/s12931-021-01807-8

34344376