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Eur J Health Econ. 2017 Jan;18(1):73-82. doi: 10.1007/s10198-015-0759-9. Epub 2016 Jan 7.

Cost-of-illness analysis and regression modeling in cystic fibrosis: a retrospective prevalence-based study.

Author information

1
Institute of Health Economics and Technological Assessment, Prague, Czech Republic.
2
Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University in Prague, Prague, Czech Republic.
3
Department of Pneumology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
4
Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
5
Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Úvalu 84, 15006, Prague 5, Czech Republic.
6
Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
7
Division of Health Insurance, University Hospital Motol, Prague, Czech Republic.
8
Department of Children's Infectious Diseases, Faculty of Medicine of Masaryk University, University Hospital, Brno, Czech Republic.
9
Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Úvalu 84, 15006, Prague 5, Czech Republic. Milan.Macek.Jr@LFmotol.cuni.cz.

Abstract

BACKGROUND:

Economic data pertaining to cystic fibrosis (CF), is limited in Europe generally, and completely lacking in Central and Eastern Europe. We performed an analysis of all direct costs associated with CF relative to key disease features and laboratory examinations.

METHODS:

A retrospective prevalence-based cost-of-illness (COI) study was performed in a representative cohort of 242 CF patients in the Czech Republic, which represents about 65 % of all Czech CF patients. Medical records and invoices to health insurance companies for reference year 2010 were analyzed.

RESULTS:

The mean total health care costs were €14,486 per patient, with the majority of the costs going towards medicinal products and devices (€10,321). Medical procedures (€2676) and inpatient care (€1829) represented a much smaller percentage of costs. A generalized linear model showed that the strongest cost drivers, for all cost categories, were associated with patient age and lung disease severity (assessed using the FEV1 spirometric parameter), when compounded by chronic Pseudomonas aeruginosa airway infections. Specifically, maximum total costs are around the age 16 years; a FEV1 increase of 1 % point represented a cost decrease of: 0.9 % (medicinal products), 1.7 % (total costs), 2.8 % (procedures) and 7.0 % (inpatient care).

CONCLUSIONS:

COI analysis and regression modeling using the most recent data available can provide a better understanding of the overall economic CF burden. A comparison of our results with other methodologically similar studies demonstrates that although overall costs may differ, FEV1 can nonetheless be utilized as a generally transferrable indicator of the relative economic impact of CF.

KEYWORDS:

Cost-of-illness; Cystic fibrosis; Disease severity; FEV1; Generalized linear model; Health care costs

PMID:
26743971
DOI:
10.1007/s10198-015-0759-9
[Indexed for MEDLINE]

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