Nationwide trends in the medical care costs of privately insured patients with cystic fibrosis (CF), 2001-2007

Becky A. Briesacher, Alexandra Quittner, Hassan Fouayzi, Jie Zhang, Andrine Swensen

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background Longer survival of patients with cystic fibrosis (CF) has been linked to initiation of national newborn screening, new therapies that prevent and treat pulmonary exacerbations, and closer monitoring of health outcomes. However, few studies have examined the economic impact of these medical advances on costs, and none have examined these costs longitudinally. Methods We used a nationwide database of the healthcare claims of privately insured individuals with CF between 2001 and 2007. Study subjects had at least two claims with diagnoses of CF (ICD-277.xx). We extracted inpatient admissions, outpatient visits, prescribed therapies, and screening procedures and then calculated all-cause medical utilization and annual medical costs, adjusted for inflation. We adjusted for comorbidity burden and tested longitudinal time trends using regression models. Results We identified 3,273 individuals with CF. Overall, the costs of prescription drugs, outpatient visits, and durable medical equipment increased by 59% during the 7-year period ($18,715 in 2001 vs. $29,718 in 2007, P < 0.001). The proportion of individuals hospitalized increased from 24.0% to 38.9%, P < 0.001. Annual testing of pulmonary function increased 53% (49.9% in 2001 to 76.3% in 2007, P < 0.001) and respiratory cultures more than doubled (27.9-67.5%, P < 0.001). Use of CF-related therapies also significantly increased (dornase alfa, 32.1-52.4%, P < 0.001; oral antibiotics, 54.1-71.8%, P = 0.007). Analyses by age showed the largest increases in total medical care costs occurred for the oldest CF patients (aged >30; $20,536 in 2001 to $56,116 in 2007, P < 0.001) and the youngest (aged <11; $3,060 in 2001 to $31,723 in 2007, P < 0.001). Conclusions Although improvements in diagnosis and treatment have yielded substantial benefits, they have come at considerable cost, both in terms of treatment burden and healthcare dollars.

Original languageEnglish
Pages (from-to)770-776
Number of pages7
JournalPediatric Pulmonology
Volume46
Issue number8
DOIs
StatePublished - Aug 1 2011

Fingerprint

Cystic Fibrosis
Health Care Costs
Costs and Cost Analysis
Durable Medical Equipment
Outpatients
Delivery of Health Care
Medical Economics
Prescription Drugs
Economic Inflation
Therapeutics
Comorbidity
Inpatients
Newborn Infant
Databases
Lung
Survival
Health

Keywords

  • cystic fibrosis
  • healthcare utilization

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Nationwide trends in the medical care costs of privately insured patients with cystic fibrosis (CF), 2001-2007. / Briesacher, Becky A.; Quittner, Alexandra; Fouayzi, Hassan; Zhang, Jie; Swensen, Andrine.

In: Pediatric Pulmonology, Vol. 46, No. 8, 01.08.2011, p. 770-776.

Research output: Contribution to journalArticle

Briesacher, Becky A. ; Quittner, Alexandra ; Fouayzi, Hassan ; Zhang, Jie ; Swensen, Andrine. / Nationwide trends in the medical care costs of privately insured patients with cystic fibrosis (CF), 2001-2007. In: Pediatric Pulmonology. 2011 ; Vol. 46, No. 8. pp. 770-776.
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abstract = "Background Longer survival of patients with cystic fibrosis (CF) has been linked to initiation of national newborn screening, new therapies that prevent and treat pulmonary exacerbations, and closer monitoring of health outcomes. However, few studies have examined the economic impact of these medical advances on costs, and none have examined these costs longitudinally. Methods We used a nationwide database of the healthcare claims of privately insured individuals with CF between 2001 and 2007. Study subjects had at least two claims with diagnoses of CF (ICD-277.xx). We extracted inpatient admissions, outpatient visits, prescribed therapies, and screening procedures and then calculated all-cause medical utilization and annual medical costs, adjusted for inflation. We adjusted for comorbidity burden and tested longitudinal time trends using regression models. Results We identified 3,273 individuals with CF. Overall, the costs of prescription drugs, outpatient visits, and durable medical equipment increased by 59{\%} during the 7-year period ($18,715 in 2001 vs. $29,718 in 2007, P < 0.001). The proportion of individuals hospitalized increased from 24.0{\%} to 38.9{\%}, P < 0.001. Annual testing of pulmonary function increased 53{\%} (49.9{\%} in 2001 to 76.3{\%} in 2007, P < 0.001) and respiratory cultures more than doubled (27.9-67.5{\%}, P < 0.001). Use of CF-related therapies also significantly increased (dornase alfa, 32.1-52.4{\%}, P < 0.001; oral antibiotics, 54.1-71.8{\%}, P = 0.007). Analyses by age showed the largest increases in total medical care costs occurred for the oldest CF patients (aged >30; $20,536 in 2001 to $56,116 in 2007, P < 0.001) and the youngest (aged <11; $3,060 in 2001 to $31,723 in 2007, P < 0.001). Conclusions Although improvements in diagnosis and treatment have yielded substantial benefits, they have come at considerable cost, both in terms of treatment burden and healthcare dollars.",
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AB - Background Longer survival of patients with cystic fibrosis (CF) has been linked to initiation of national newborn screening, new therapies that prevent and treat pulmonary exacerbations, and closer monitoring of health outcomes. However, few studies have examined the economic impact of these medical advances on costs, and none have examined these costs longitudinally. Methods We used a nationwide database of the healthcare claims of privately insured individuals with CF between 2001 and 2007. Study subjects had at least two claims with diagnoses of CF (ICD-277.xx). We extracted inpatient admissions, outpatient visits, prescribed therapies, and screening procedures and then calculated all-cause medical utilization and annual medical costs, adjusted for inflation. We adjusted for comorbidity burden and tested longitudinal time trends using regression models. Results We identified 3,273 individuals with CF. Overall, the costs of prescription drugs, outpatient visits, and durable medical equipment increased by 59% during the 7-year period ($18,715 in 2001 vs. $29,718 in 2007, P < 0.001). The proportion of individuals hospitalized increased from 24.0% to 38.9%, P < 0.001. Annual testing of pulmonary function increased 53% (49.9% in 2001 to 76.3% in 2007, P < 0.001) and respiratory cultures more than doubled (27.9-67.5%, P < 0.001). Use of CF-related therapies also significantly increased (dornase alfa, 32.1-52.4%, P < 0.001; oral antibiotics, 54.1-71.8%, P = 0.007). Analyses by age showed the largest increases in total medical care costs occurred for the oldest CF patients (aged >30; $20,536 in 2001 to $56,116 in 2007, P < 0.001) and the youngest (aged <11; $3,060 in 2001 to $31,723 in 2007, P < 0.001). Conclusions Although improvements in diagnosis and treatment have yielded substantial benefits, they have come at considerable cost, both in terms of treatment burden and healthcare dollars.

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