IDEAS home Printed from https://ideas.repec.org/a/spr/pharme/v35y2017i10d10.1007_s40273-017-0530-4.html
   My bibliography  Save this article

Estimating Direct Cost of Cystic Fibrosis Care Using Irish Registry Healthcare Resource Utilisation Data, 2008–2012

Author

Listed:
  • Abaigeal D. Jackson

    (UCD Belfield)

  • Andrew L. Jackson

    (Trinity College Dublin)

  • Godfrey Fletcher

    (UCD Belfield)

  • Gerardine Doyle

    (Quinn School of Business)

  • Mary Harrington

    (UCD Belfield)

  • Shijun Zhou

    (UCD Belfield)

  • Fiona Cullinane

    (UCD Belfield)

  • Charles Gallagher

    (St Vincent’s University Hospital)

  • Edward McKone

    (St Vincent’s University Hospital)

Abstract

Background Understanding the determinants of cost of cystic fibrosis (CF) care and health outcomes may be useful for financial planning for the delivery of CF services. Registries contain information otherwise unavailable to healthcare activity/cost monitoring systems. We estimated the direct medical cost of CF care using registry data and examined how cost was affected by patient characteristics and CF gene (CF Transmembrane Conductance Regulator [CFTR]) mutation. Methods Healthcare resource utilisation data (2008–2012) were obtained for CF patients enrolled with the Irish CF Registry by 2013 from linked registry and national hospitalisation database records. Mean annual hospitalisation and medication per-patient costs were estimated by demographic profile, CFTR mutation, clinical status, and CF co-morbidity, and were presented in 2014 euro values. A mixed-effects regression model was used to examine the effect of demographic, CFTR mutation, and clinical outcomes on the log10 cost of direct medical CF care. Results Using 4261 observations from 1100 patients, we found that the median annual total cost per patient increased over the period 2008–2012 from €12,659 to €16,852, inpatient bed-day cost increased from €14,026 to €17,332, and medication cost increased from €5863 to €12,467. Homozygous F508-CFTR mutation (class II) cost was highest and milder mutation (class IV/V) cost was 49% lower. Baseline estimated cost in 2008 for a hypothetical underweight, homozygous F508del-CFTR 6-year-old female without chronic Pseudomonas aeruginosa/Staphylococcus aureus, CF-related diabetes (CFRD) or methicillin-resistant S. aureus (MRSA), and with a poor percent predicted forced expiratory volume in 1 s (ppFEV1) was €10,113, and was €21,082 in a 25-year-old with the same hypothetical profile. Chronic P. aeruginosa infection increased baseline cost by 39%, CF co-morbidity diabetes by 18%, and frequency of pulmonary exacerbation by 15%. Underweight, declining ppFEV1, chronic S. aureus colonisation, and time also influenced cost. Conclusions CFTR mutation is an important factor influencing the cost of CF care. Costs differ among cohorts of CF patients eligible to access new and emerging CFTR repair therapies. These findings support the evaluation of outcome-associated cost in CFTR mutation-specific CF patient groups.

Suggested Citation

  • Abaigeal D. Jackson & Andrew L. Jackson & Godfrey Fletcher & Gerardine Doyle & Mary Harrington & Shijun Zhou & Fiona Cullinane & Charles Gallagher & Edward McKone, 2017. "Estimating Direct Cost of Cystic Fibrosis Care Using Irish Registry Healthcare Resource Utilisation Data, 2008–2012," PharmacoEconomics, Springer, vol. 35(10), pages 1087-1101, October.
  • Handle: RePEc:spr:pharme:v:35:y:2017:i:10:d:10.1007_s40273-017-0530-4
    DOI: 10.1007/s40273-017-0530-4
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40273-017-0530-4
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s40273-017-0530-4?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Daniela Eidt-Koch & Thomas Wagner & Thomas Mittendorf & J.-Matthias Schulenburg, 2010. "Outpatient medication costs of patients with cystic fibrosis in Germany," Applied Health Economics and Health Policy, Springer, vol. 8(2), pages 111-118, March.
    2. Kees Van Gool & Richard Norman & Martin B Delatycki & Jane Hall & John Massie, 2011. "Understanding the costs of care for cystic fibrosis: an analysis by age and severity. CHERE Working Paper 2011/1," Working Papers 2011/1, CHERE, University of Technology, Sydney.
    3. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Yuanyuan Gu & Sonia García-Pérez & John Massie & Kees Gool, 2015. "Cost of care for cystic fibrosis: an investigation of cost determinants using national registry data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(7), pages 709-717, September.
    2. Paal Joranger & Arild Nesbakken & Halfdan Sorbye & Geir Hoff & Arne Oshaug & Eline Aas, 2020. "Survival and costs of colorectal cancer treatment and effects of changing treatment strategies: a model approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 321-334, April.
    3. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    4. Mark Oppe & Daniela Ortín-Sulbarán & Carlos Vila Silván & Anabel Estévez-Carrillo & Juan M. Ramos-Goñi, 2021. "Cost-effectiveness of adding Sativex® spray to spasticity care in Belgium: using bootstrapping instead of Monte Carlo simulation for probabilistic sensitivity analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 711-721, July.
    5. Laurence M. Djatche & Stefan Varga & Robert D. Lieberthal, 2018. "Cost-Effectiveness of Aspirin Adherence for Secondary Prevention of Cardiovascular Events," PharmacoEconomics - Open, Springer, vol. 2(4), pages 371-380, December.
    6. Ties Hoomans & Johan Severens & Nicole Roer & Gepke Delwel, 2012. "Methodological Quality of Economic Evaluations of New Pharmaceuticals in the Netherlands," PharmacoEconomics, Springer, vol. 30(3), pages 219-227, March.
    7. Khan, Md. Tajuddin & Kishore, Avinash & Joshi, Pramod Kumar, 2016. "Gender dimensions on farmers’ preferences for direct-seeded rice with drum seeder in India:," IFPRI discussion papers 1550, International Food Policy Research Institute (IFPRI).
    8. Noémi Kreif & Richard Grieve & M. Zia Sadique, 2013. "Statistical Methods For Cost‐Effectiveness Analyses That Use Observational Data: A Critical Appraisal Tool And Review Of Current Practice," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 486-500, April.
    9. Barbara Graaff & Lei Si & Amanda L. Neil & Kwang Chien Yee & Kristy Sanderson & Lyle C. Gurrin & Andrew J. Palmer, 2017. "Population Screening for Hereditary Haemochromatosis in Australia: Construction and Validation of a State-Transition Cost-Effectiveness Model," PharmacoEconomics - Open, Springer, vol. 1(1), pages 37-51, March.
    10. Christopher Fitzpatrick & Katherine Floyd, 2012. "A Systematic Review of the Cost and Cost Effectiveness of Treatment for Multidrug-Resistant Tuberculosis," PharmacoEconomics, Springer, vol. 30(1), pages 63-80, January.
    11. Hareth Al-Janabi & Terry N. Flynn & Joanna Coast, 2011. "Estimation of a Preference-Based Carer Experience Scale," Medical Decision Making, , vol. 31(3), pages 458-468, May.
    12. Round, Jeff, 2012. "Is a QALY still a QALY at the end of life?," Journal of Health Economics, Elsevier, vol. 31(3), pages 521-527.
    13. Ching-Yun Wei & Ruben G. W. Quek & Guillermo Villa & Shravanthi R. Gandra & Carol A. Forbes & Steve Ryder & Nigel Armstrong & Sohan Deshpande & Steven Duffy & Jos Kleijnen & Peter Lindgren, 2017. "A Systematic Review of Cardiovascular Outcomes-Based Cost-Effectiveness Analyses of Lipid-Lowering Therapies," PharmacoEconomics, Springer, vol. 35(3), pages 297-318, March.
    14. Jose L Burgos & Thomas L Patterson & Joshua S Graff-Zivin & James G Kahn & M Gudelia Rangel & M Remedios Lozada & Hugo Staines & Steffanie A Strathdee, 2016. "Cost-Effectiveness of Combined Sexual and Injection Risk Reduction Interventions among Female Sex Workers Who Inject Drugs in Two Very Distinct Mexican Border Cities," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-15, February.
    15. Najmiatul Fitria & Antoinette D. I. Asselt & Maarten J. Postma, 2019. "Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 407-417, April.
    16. Thomas Grochtdreis & Hans-Helmut König & Alexander Dobruschkin & Gunhild von Amsberg & Judith Dams, 2018. "Cost-effectiveness analyses and cost analyses in castration-resistant prostate cancer: A systematic review," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-25, December.
    17. Kim Jeong & John Cairns, 2013. "Review of economic evidence in the prevention and early detection of colorectal cancer," Health Economics Review, Springer, vol. 3(1), pages 1-10, December.
    18. Susan Griffin & Helen Weatherly & Gerry Richardson & Mike Drummond, 2008. "Methodological issues in undertaking independent cost-effectiveness analysis for NICE: the case of therapies for ADHD," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(2), pages 137-145, May.
    19. William Wong & Josh Carlson & Rahber Thariani & David Veenstra, 2010. "Cost Effectiveness of Pharmacogenomics," PharmacoEconomics, Springer, vol. 28(11), pages 1001-1013, November.
    20. Fleurbaey, Marc & Zuber, Stéphane, 2017. "Fair management of social risk," Journal of Economic Theory, Elsevier, vol. 169(C), pages 666-706.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:35:y:2017:i:10:d:10.1007_s40273-017-0530-4. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.