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

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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.

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Acknowledgments

Supported by the Czech Ministry of Health 00064203 to MM and PD; NT/13770-4; NF-CZ11-PDP-3-003-2014, COST - LD14073 and CZ.2.16/3.1.00/24022OPPK to MM. We acknowledge administrative help from Ms. Ivana Funkova and support from the Czech CF Association (www.cfklub.cz).

Disclosure

This study was partially supported by Vertex Pharmaceuticals (USA) to the Institute of Health Economics and Technological Assessment in Prague (TM, JK, JJ, and TD). The remaining authors do not have any conflict of interest that could influence the content or processing of this manuscript.

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Authors and Affiliations

  1. Institute of Health Economics and Technological Assessment, Prague, Czech Republic

    Tomáš Mlčoch, Jitka Jirčíková & Tomáš Doležal

  2. Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University in Prague, Prague, Czech Republic

    Jiří Klimeš

  3. Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic

    Věra Vávrová, Veronika Skalická, Dana Zemková & Alena Bílková

  4. 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

    Marek Turnovec, Veronika Krulišová & Milan Macek Jr.

  5. Department of Pneumology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic

    Libor Fila

  6. Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic

    Klára Vilimovská Dědečková & Pavel Dřevínek

  7. Division of Health Insurance, University Hospital Motol, Prague, Czech Republic

    Vladimíra Frühaufová, Zuzana Friedmannová & Radovan Drnek

  8. Department of Children’s Infectious Diseases, Faculty of Medicine of Masaryk University, University Hospital, Brno, Czech Republic

    Lukáš Homola

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  1. Tomáš Mlčoch
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Correspondence to Milan Macek Jr..

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Mlčoch, T., Klimeš, J., Fila, L. et al. Cost-of-illness analysis and regression modeling in cystic fibrosis: a retrospective prevalence-based study. Eur J Health Econ 18, 73–82 (2017). https://doi.org/10.1007/s10198-015-0759-9

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