Burden of illness in idiopathic pulmonary fibrosis

Abstract

Background:

Idiopathic pulmonary fibrosis is a life-threatening condition, and few data concerning the impact on healthcare utilization and associated costs are available. The objective of this study was to describe the burden of illness (comorbidity, healthcare resource utilization, and associated costs) in patients with idiopathic pulmonary fibrosis.

Methods:

Two cohorts (patients with idiopathic pulmonary fibrosis and matched controls) were retrospectively identified from US claims databases between January 1, 2001 and September 30, 2008. Cases with idiopathic pulmonary fibrosis were defined by age of 55 years or older and either two or more claims with a code for idiopathic fibrosing alveolitis (ICD-9 516.3), or one claim with ICD 516.3 and a subsequent claim with a code for post-inflammatory pulmonary fibrosis (ICD-9 515). The prevalence and incidence of pre-selected comorbidities, healthcare resource utilization (hospital, outpatient, drugs), and direct medical costs were assessed in each cohort.

Results:

A total of 9286 patients with idiopathic pulmonary fibrosis were identified. When compared with age- and gender-matched controls, these patients were at significantly increased risk for comorbidities including pulmonary hypertension and emphysema. The all-cause hospital admission rate (0.5 per person-year) and the all-cause outpatient visit rate (28.0 per person-year) were both ∼2-fold higher than in controls. Total direct costs for patients with idiopathic pulmonary fibrosis were $26,378 per person-year; the incremental costs over controls were $12,124 (2008 value).

Conclusions:

Patients with idiopathic pulmonary fibrosis experience increased comorbidity, healthcare resource utilization, and direct medical costs compared to controls.

Keywords::

• Idiopathic pulmonary fibrosis
• Comorbidity
• Costs and cost analysis
• Resource utilization

Transparency

Declaration of funding

This study was sponsored by Actelion Pharmaceuticals Ltd., Switzerland.

Declaration of financial/other relationships

HRC has served as a consultant to Actelion in the past. HRC received no payment for work on this project, and currently serves as a consultant for Fibrogen, Gilead, InterMune, and Onyx. He also has received grants and contracts from Boehringer Ingelheim and Genentech. AW and SL have disclosed that they are employed by United BioSource Corporation, a company that received funding from Actelion to conduct this study. DCH has disclosed that he is an employee of Hayflinger Analytic Services, a company that also received funding from Actelion to conduct this study. DMR and EH have disclosed that they are employees of Actelion Pharmaceuticals LTD.

Acknowledgments

Statistical evaluations were performed by AW and SL. HRC and AJW contributed equally to the writing of this article.