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

Tomáš Mlčoch, Jiří Klimeš, Libor Fila, Věra Vávrová, Veronika Skalická, Marek Turnovec, Veronika Krulišová, Jitka Jirčíková, Dana Zemková, Klára Vilimovská Dědečková, Alena Bílková, Vladimíra Frühaufová, Lukáš Homola, Zuzana Friedmannová, Radovan Drnek, Pavel Dřevínek, Tomáš Doležal and Milan Macek ()
Additional contact information
Tomáš Mlčoch: Institute of Health Economics and Technological Assessment
Jiří Klimeš: Charles University in Prague
Libor Fila: Charles University in Prague and University Hospital Motol
Věra Vávrová: Charles University in Prague and University Hospital Motol
Veronika Skalická: Charles University in Prague and University Hospital Motol
Marek Turnovec: Charles University in Prague and University Hospital Motol
Veronika Krulišová: Charles University in Prague and University Hospital Motol
Jitka Jirčíková: Institute of Health Economics and Technological Assessment
Dana Zemková: Charles University in Prague and University Hospital Motol
Klára Vilimovská Dědečková: Charles University in Prague and University Hospital Motol
Alena Bílková: Charles University in Prague and University Hospital Motol
Vladimíra Frühaufová: University Hospital Motol
Lukáš Homola: University Hospital
Zuzana Friedmannová: University Hospital Motol
Radovan Drnek: University Hospital Motol
Pavel Dřevínek: Charles University in Prague and University Hospital Motol
Tomáš Doležal: Institute of Health Economics and Technological Assessment
Milan Macek: Charles University in Prague and University Hospital Motol

The European Journal of Health Economics, 2017, vol. 18, issue 1, No 7, 73-82

Abstract: 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: Cystic fibrosis; Cost-of-illness; Disease severity; Health care costs; FEV1; Generalized linear model (search for similar items in EconPapers)
JEL-codes: I10 I18 (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10198-015-0759-9

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