Centre for Health Economics, Leibniz University of Hannover, Hannover, Germany.
Appl Health Econ Health Policy. 2010;8(2):111-8. doi: 10.2165/11313980-000000000-00000.
Cystic fibrosis (CF) patients need specialized long-term treatment. In order to support lung function, pharmaceuticals such as bronchodilators, mucolytic agents or anti-inflammatory drugs have to be used. Oral, inhaled or intravenous antibacterial therapy is of special importance for patients who have problems with chronic bacterial colonization of the lung and airways. In case of pancreatic insufficiency, digestive enzymes have to be substituted with every meal. Furthermore, patients often need additional supplements of vitamins as well as high caloric food. All of these aspects lead to high medication use in CF patients.
To analyse outpatient medication costs for CF in Germany from a sickness funds perspective (plus some out-of-pocket payments by patients).
Medication data were evaluated from seven different outpatient CF centres. Data were recorded via medication lists by the physicians, reporting name of medication, dosage and pharmaceutical form. As the medications are mostly used long term, resource use was valued using the largest available package sizes. Prices were taken from the German 'Rote Liste' with year 2006 values. Annual and daily medication costs were analysed for different age groups. In addition, cost-influencing factors were analysed via correlation analyses.
A total of 3150 pharmaceutical records from 301 CF patients were collected. Mean annual costs for medication were €21,603 per patient (range €69-104,477). Correlation analyses showed significant correlations between costs of medication and age, co-morbidities (such as pancreatic insufficiency and diabetes mellitus) and clinical parameters such as bacterial colonization of the lung, as well as functional parameters (percent of vital capacity, forced expiratory volume in 1 second, maximal expiratory flow at 25% of forced vital capacity). For example, mean annual costs for medication were €23,815 and €14,884 for patients with and without bacterial colonization of the lung, respectively. Other correlation factors yielded similar cost dispersions between patients with and without the factors.
Costs of outpatient medication for CF patients significantly depend on age, co-morbidities and other clinical parameters. Hence, non-optimal treatment could lead to a significantly higher burden for the healthcare system.
囊性纤维化（CF）患者需要专业的长期治疗。为了支持肺功能，需要使用支气管扩张剂、黏液溶解剂或抗炎药物等药物。对于肺部和气道慢性细菌定植有问题的患者，口服、吸入或静脉用抗菌治疗尤为重要。如果存在胰腺功能不全，则需要每餐替代消化酶。此外，患者通常还需要额外补充维生素和高热量食物。所有这些方面都导致 CF 患者的药物使用量很大。
从疾病基金的角度（加上患者的一些自付费用）分析德国 CF 门诊药物的使用情况。
通过医生的药物清单评估来自七个不同 CF 门诊中心的数据。数据记录包括药物名称、剂量和药物剂型。由于这些药物大多是长期使用的，因此根据可用的最大包装尺寸来评估资源的使用情况。价格取自德国“Rote Liste”，使用 2006 年的数据。根据不同年龄组分析了年度和每日药物费用。此外，通过相关分析分析了影响成本的因素。
共收集了 301 名 CF 患者的 3150 份药物记录。每位患者的年平均药物费用为 21603 欧元（范围为 69-104477 欧元）。相关分析表明，药物费用与年龄、合并症（如胰腺功能不全和糖尿病）以及肺部细菌定植等临床参数以及功能参数（肺活量百分比、1 秒用力呼气量、最大呼气流量在用力肺活量的 25%）之间存在显著相关性。例如，肺部细菌定植的患者年平均药物费用为 23815 欧元，无肺部细菌定植的患者为 14884 欧元。其他相关因素也导致有这些因素的患者之间存在类似的费用差异。
CF 患者的门诊药物费用显著取决于年龄、合并症和其他临床参数。因此，非最佳治疗可能会给医疗保健系统带来显著的负担。
