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A Scoping Review of Healthcare Costs for Patients with Cystic Fibrosis

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Abstract

Background

Cystic fibrosis (CF), one of the most common life-shortening genetic diseases, has no cure, but people living with it have seen improvements in their health and survival. The rising life expectancy and increased availability of treatment options has likely increased the lifetime costs of people living with CF. In addition, a recent drug approval for a therapy that targets the cause of the disease is one of the most expensive drugs worldwide. In light of these circumstances, it is important to have an updated understanding of the costs of CF therapy and management. This study aims to determine the extent of available literature that quantifies CF costs.

Methods

We used a scoping review framework to identify the sources and types of evidence available to determine the costs of CF therapy and management compared to the general population or a comparable population of people with other complex chronic conditions. We searched 14 databases for peer-reviewed studies and grey literature published in English since 1998. The search was conducted in August 2013 and updated in October 2014.

Results

We identified 28 studies that estimated overall, general CF costs. Of these, three studies compare CF costs to healthcare costs of a general population and only one of those provides a direct comparison of CF costs to the general population in order to calculate the incremental cost associated with CF. We estimate there are 98 systematic reviews that quantify the costs of comparable conditions and potentially provide a comparison group for people with CF.

Conclusions

There is evidence available that attempts to quantify overall, general healthcare costs of people with CF, although much of it is outdated. However, there is much less evidence available that provides a comparison of these costs with either the general population or people with comparable conditions.

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References

  1. Cystic Fibrosis Foundation. Cystic Fibrosis Foundation Patient Registry 2012 Annual Data Report. Bethesda, MD; 2013.

  2. 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;183:1463–71.

    Article  PubMed  Google Scholar 

  3. Trivedi BP. Doorway to a cure. Discover. 2013. Available at: http://discovermagazine.com/2013/september/14-doorway-to-a-cure. Accessed 19 Nov 2015.

  4. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.

    Article  Google Scholar 

  5. Colquhoun H, Levac D, O’Brien KK, Straus S, Tricco AC, Perrier L, et al. Scoping reviews: time for clarity in definition, methods, and reporting. J Clin Epidemiol. 2014;67(12):1291–4.

    Article  PubMed  Google Scholar 

  6. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Davidoff AJ. Insurance for children with special health care needs: patterns of coverage and burden of families to provide adequate insurance. Pediatrics. 2004;114(2):394–402.

    Article  PubMed  Google Scholar 

  8. Druss BG, Marcus SC, Olfson M, Tanielian T, Elinson L, Pincus HA. Comparing the national economic burden of five chronic conditions. Health Aff. 2001;20(6):233–41.

    Article  CAS  Google Scholar 

  9. Health Resources and Services Administration, Maternal and Child Health Bureau Conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention. (2009–2010) National survey of children with special health care needs. Questionnaire Version: December 14, 2011.

  10. Chen AY, Newacheck PW. Insurance coverage and financial burden for families of children with special health care needs. Ambul Pediatr. 2006;6(4):204–9.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ramsey BW, Pepe MS, Quan JM, Otto KL, Montgomery AB, Williams-Warren J, et al. Intermittent administration of inhaled tobramycin in patients with cystic fibrosis. Cystic Fibrosis Inhaled Tobramycin Study Group. NEJM. 1999;340(1):23–30.

    Article  CAS  PubMed  Google Scholar 

  12. Woodward TC, Brown R, Sacco P, Zhang J. Budget impact model of tobramycin inhalation solution for treatment of Pseudomonas aeruginosa in cystic fibrosis patients. J Med Econ. 2010;13(3):492–9.

    Article  PubMed  Google Scholar 

  13. Colombo C, Dacco V, Loi S, Anelli M, Alicandro G. Analysis of cost drivers for health care services use in cystic fibrosis patients: the experience of the Milan cystic fibrosis center. J Cyst Fibros. 2014;13:S104.

    Article  Google Scholar 

  14. Strong M, Harr B. Burden of disease and out-of-pocket costs associated with CF for patients and caregivers in the United States. Pediatr Pulmonol. 2010;45:447–8.

    Google Scholar 

  15. Krauth C, Jalilvand N, Welte T, Busse R. Cystic fibrosis: cost of illness and considerations for the economic evaluation of potential therapies. Pharmacoeconomics. 2003;21(14):1001–24.

    Article  PubMed  Google Scholar 

  16. Balinsky W, Zhu CW. Pediatric cystic fibrosis: evaluating costs and genetic testing. J Pediatr Health Care. 2004;18(1):30–4.

    Article  PubMed  Google Scholar 

  17. Lieu TA, Ray GT, Farmer G, Shay GF. The cost of medical care for patients with cystic fibrosis in a health maintenance organization. Pediatrics. 1999;103(6):e72.

    Article  CAS  PubMed  Google Scholar 

  18. Ouyang L, Grosse SD, Amendah DD, Schechter MS. Healthcare expenditures for privately insured people with cystic fibrosis. Pediatr Pulmonol. 2009;44(10):989–96.

    Article  PubMed  Google Scholar 

  19. Baumann U, Stocklossa C, Greiner W, von der Schulenburg JM, von der Hardt H. Cost of care and clinical condition in paediatric cystic fibrosis patients. J Cyst Fibros. 2003;2(2):84–90.

    Article  PubMed  Google Scholar 

  20. Becker CC, Clements K, DeLong K, Harrow B, O’Sullivan A. Economic burden of cystic fibrosis in the US: costs of care by disease severity and age. Value Health. 2011;14(7):A490.

    Article  Google Scholar 

  21. 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(8):770–6.

    Article  PubMed  Google Scholar 

  22. Broder MS, Nasr SZ, Chang E, Villa KF. Utilization and healthcare charges in an insured US cystic fibrosis (CF) patient population. J Cyst Fibros. 2011;10:S97.

    Article  Google Scholar 

  23. Colombo C, Daccò V, Alicandro G, Loi S, Mazzi S, Lucioni C, et al. Cost of cystic fibrosis: analysis of treatment costs in a specialized center in Northern Italy. Adv Ther. 2013;30(2):165–75.

    Article  PubMed  Google Scholar 

  24. Dewitt EM, Grussemeyer CA, Friedman JY, Dinan MA, Lin L, Schulman KA, Reed SD. 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 multicenter clinical trial. Value Health. 2012;15(2):277–83.

    Article  PubMed  Google Scholar 

  25. Eakin MN, Bilderback A, Ridge A, Quittner AL, Zhang J, Riekert KA. Out-of-pocket costs for medications in the I change adherence and raise expectations (iCARE) study. Pediatr Pulmonol. 2011;46:420.

    Google Scholar 

  26. Gu Y, Garcia-Perez S, Massie J, van Gool K. Cost of care for cystic fibrosis: an investigation of cost determinants using national registry data. Eur J Health Econ. 2015;16(7):709–17.

    Article  PubMed  Google Scholar 

  27. Harrow B, Becker CC, Buikema A. High cost cystic fibrosis patients as identified in a us claims database: a closer look at the tail. Value Health. 2011;14(7):A491.

    Article  Google Scholar 

  28. Heimeshoff M, Hollmeyer H, Schreyogg J, Tiemann O, Staab D. Cost of illness of cystic fibrosis in Germany: results from a large cystic fibrosis centre. Pharmacoeconomics. 2012;30(9):763–77.

    Article  PubMed  Google Scholar 

  29. Huot L, Durieu I, Bourdy S, Ganne C, Bellon G, Colin C, et al. Evolution of costs of care for cystic fibrosis patients after clinical guidelines implementation in a French network. J Cyst Fibros. 2008;7(5):403–8.

    Article  PubMed  Google Scholar 

  30. Jarrett J, Lies R, Mugford M, Legh-Smith J. The cost of paediatric cystic fibrosis to the NHS in the Eastern Region. J Cyst Fibros. 2008;7:S117.

    Article  Google Scholar 

  31. Klimes J, Dolezal T, Vavrova V, Turnovec M, Skalicka V, Mlcoch T. Economic burden of cystic fibrosis (CF): prevalence based cost of illness analysis related to the lung disease severity in Czech CF patients. J Cyst Fibros. 2014;13:S11.

    Article  Google Scholar 

  32. Levy J, Rosenberg M, Farrell PM. The direct medical costs of pediatric cystic fibrosis. Pediatr Pulmonol. 2013;48:375.

    Google Scholar 

  33. O’Sullivan A, Sullivan J, Higuchi K, Montgomery A. Health care utilization and costs for cystic fibrosis patients with pulmonary infections. Manag Care. 2011;20(2):37–44.

    PubMed  Google Scholar 

  34. Okumura MJ, Campbell AD, Nasr SZ, Davis MM. Inpatient health care use among adult survivors of chronic childhood illnesses in the United States. Arch Pediatr Adolesc Med. 2006;160(10):1054–60.

    Article  PubMed  Google Scholar 

  35. Rosenberg MA, Farrell PM. Assessing the cost of cystic fibrosis diagnosis and treatment. J Pediatr. 2005;147(3 Suppl):S101–5.

    Article  PubMed  Google Scholar 

  36. Sansgiry S, Joish V, Boklage S, Goyal RK, Seal B, Sethi S. Pseudomonas aeruginosa related economic burden stratified by comorbidity in cystic fibrosis patients. Value Health. 2010;13(7):A433.

    Article  Google Scholar 

  37. Sansgiry SS, Joish V, Boklage S, Goyal RK, Sethi S. Impact of pseudomonas aeruginosa infections on direct medical costs among cystic fibrosis patients. Pediatr Pulmonol. 2010;45:451.

    Google Scholar 

  38. Sansgiry SS, Joish VN, Boklage S, Goyal RK, Chopra P, Sethi S. Economic burden of Pseudomonas aeruginosa infection in patients with cystic fibrosis. J Med Econ. 2012;15(2):219–24.

    Article  PubMed  Google Scholar 

  39. Schwerner H, Mellody T, Goldstein AB, Wansink D, Sullivan V, Yelenik SN, et al. Evaluating the impact of a disease management program for chronic complex conditions at two large northeast health plans using a control group methodology. Dis Manag. 2006;9(1):34–44.

    Article  PubMed  Google Scholar 

  40. van Gool K, Norman R, Delatycki MB, Hall J, Massie J. Understanding the costs of care for cystic fibrosis: an analysis by age and health state. Value Health. 2013;16(2):345–55.

    Article  PubMed  Google Scholar 

  41. Zhang J, Marynchenko M, Chopra P, Ohashi E, Signorovitch J, Wu E. Annual healthcare costs for patients with cystic fibrosis from a medicaid perspective. Pediatr Pulmonol. 2012;47:443–4.

    Google Scholar 

  42. 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(10):1159–66.

    Article  CAS  PubMed  Google Scholar 

  43. Cystic Fibrosis Foundation Patient Registry 2013 Annual Data Report to the Center Directors. In. Bethesda, MD: Cystic Fibrosis Foundation; 2014.

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Acknowledgements

The research and one author were funded by a grant from the Cystic Fibrosis Foundation. There was no funding for manuscript preparation and the funding body played no role in the collection, analysis, or interpretation of data or in the manuscript preparation or decision to submit the manuscript for publication. The funding body did provide expert feedback on the protocol design.

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Correspondence to Ilene L. Hollin.

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Conflict of Interest

ILH has a pending grant from the study funder (Cystic Fibrosis Foundation) and has received honoraria from the same foundation for unrelated work. KAR declares no conflicts of interest.

Authors’ contributions

ILH carried out the literature search and drafted the manuscript. KAR conceived of the study, secured funding and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.

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Hollin, I.L., Robinson, K.A. A Scoping Review of Healthcare Costs for Patients with Cystic Fibrosis. Appl Health Econ Health Policy 14, 151–159 (2016). https://doi.org/10.1007/s40258-015-0211-4

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