Impact of Pseudomonas aeruginosa on resource utilization and costs in patients with exacerbated non-cystic fibrosis bronchiectasis

Abstract

Aims

Non‐cystic fibrosis bronchiectasis (NCFB) is a chronic progressive respiratory disorder occurring at a rate ranging from 4.2 to 278.1 cases per 100,000 persons, depending on age, in the United States. For many patients with NCFB, the presence of Pseudomonas aeruginosa (PA) makes treatment more complicated and typically has worse outcomes. Management of NCFB can be challenging, warranting a better understanding of the burden of illness for NCFB, treatments applied, healthcare resources used, and subsequent treatment costs. Comparing patients diagnosed with exacerbated NCFB, with or without PA on antibiotic utilization, treatments, and healthcare resources utilization and costs was the purpose of this study.

Materials and methods

This was a retrospective cohort study of commercial claims from IQVIA’s PharMetrics Plus database (January 1,2006–December 31, 2020). Study patients with a diagnosis of NCFB were stratified into two groups based on the presence or absence of PA, then followed to identify demographic characteristics, comorbid conditions, antibiotic treatment regimen prescribed, healthcare resources utilized, and costs of care.

Results

The results showed that patients with exacerbated NCFB who were PA⁺ had significantly more oral antibiotic fills per patient per year, more inpatient admissions with a longer length of stay, and more outpatient encounters than those who were PA⁻. For costs, PA⁺ patients also had significantly greater total healthcare costs per patient when compared to those who were PA⁻.

Conclusion

Exacerbated NCFB with PA⁺ was associated with increased antibiotic usage, greater resource utilization, and increased costs. The major contributor to the cost differences was the use of inpatient services. Treatment strategies aimed at reducing the need for inpatient treatment could lessen the disparities observed in patients with NCFB.

Keywords:

• Non‐cystic fibrosis bronchiectasis
• healthcare resource utilization

JEL CLASSIFICATION CODES:

• I10
• I1
• I
• I12

Transparency

Declaration of funding

The study was sponsored by Zambon S.p.A.

Declaration of financial/other relationships

PRECISIONheor received funding for the study. M.F. is a consultant for PRECISIONheor. M.E.M. and F.P. are employees of the Zambon Group.

Author contributions

M.F. takes full responsibility for the article, including the data and analysis. M.F. drafted and revised the manuscript. M.F., M.E.M., F.P., and S.D. conceptualized and designed the study. M.F. and PRECISIONheor were responsible for the analysis. All authors contributed to data interpretation and manuscript revision.

Acknowledgements

Maia R. Emden, Naomi C. Sacks, Katie Everson, and Ronae McLin were employees at PRECISIONheor when the study was conceptualized and initiated. They provided input on the study design and initial results interpretation.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.