Innovative assessment of inpatient and pulmonary drug costs for children with cystic fibrosis
| Autor: | Philip M. Farrell, Marjorie A. Rosenberg, Joseph F. Levy |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Drug education.field_of_study Pediatrics medicine.medical_specialty Newborn screening Total cost business.industry media_common.quotation_subject Medical record Population medicine.disease Cystic fibrosis 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Pediatrics Perinatology and Child Health Inpatient stays medicine 030212 general & internal medicine education Cost of care business health care economics and organizations media_common |
| Zdroj: | Pediatric Pulmonology. 51:1295-1303 |
| ISSN: | 8755-6863 |
| DOI: | 10.1002/ppul.23554 |
| Popis: | SummaryBackground Previous estimates of the cost of care for pediatric Cystic fibrosis (CF) showed wide variation, without specific summary of pulmonary drug costs. Methods Enrolled CF children from the Wisconsin newborn screening trial were evaluated quarterly per protocol. Assessments systematically included all treatments, hospitalizations, and nutritional and pulmonary outcomes. Direct medical costs from hospital billing and medical records from 1989 to 2010 were used to describe costs by age-ranges and subgroups throughout follow-up. Outpatient drugs were separated by category (pulmonary/otherwise). Inpatient and drug costs were examined by clinical risk factors (presence of meconium ileus, pancreatic insufficiency, and expected severity of genetic mutations). Results Seventy-three children were followed for an average of 12.9 years with an average annual total cost of care of $24,768. Outpatient drug costs (53%) and hospitalizations (32%) represented the majority of costs. Drug costs were 48% for pulmonary indications and 52% for non-pulmonary. Pulmonary drug costs for children taking dornase were 54% of their drug costs while pulmonary drug costs were only 31% for children not taking dornase. Significant differences in frequency of inpatient stays existed for children with pancreatic insufficiency. Substantial differences in treatment costs exist as children age and by clinical risk factor. Conclusion This study provides more accurate longitudinal estimates of CF care costs throughout childhood and shows that increasing age, pancreatic insufficiency, use of dornase, and hospitalizations are key determinants of cost. These estimates can be included in evaluations of the cost-effectiveness of new, highly expensive treatments being introduced for any CF population. Pediatr Pulmonol. 2016; 9999:1–9. © 2016 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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