RESearch on HealthcAre PErformance (RESHAPE), Claude Bernard Lyon 1 University, 8 Avenue Rockefeller, Lyon, F-69003.; Hospices Civils de Lyon, Lyon Sud Hospital, Cystic Fibrosis Center (CRCM), Department of Internal Medicine, 165 Chemin du Grand Revoyet, Pierre-Bénite, F-69495.
PELyon, PharmacoEpidemiologie Lyon, 210 Avenue Jean Jaurès, Lyon, F-69007.
J Cyst Fibros. 2022 Jan;21(1):88-95. doi: 10.1016/j.jcf.2021.03.025. Epub 2021 Apr 15.
Better insights into the natural course of cystic fibrosis (CF) have led to treatment approaches that have improved pulmonary health and increased the life expectancy of affected individuals. This study evaluated how the combination of modified demographics and changes in CF management impacted resource consumption and the cost of care.
Medical records of CF patients from 2006 to 2016 in the French CF Registry were linked to their corresponding claims data (SNDS). Medications, medical visits, procedures, hospitalisations, and indirect costs were annualized by calendar year from 2006 to 2017.
Of the 7,671 patients included in the French CF Registry, 6,187 patients (80.7%) were linked to the SNDS (51.9% male, mean age = 24.7 years). The average cost per patient was €14,174 in 2006, €21,920 in 2011 and €44,585 in 2017. Costs associated with hospital stays increased from €3,843 per patient in 2006 to €6,741 in 2017. In 2017, the mean cost per CF patient was allocated as follows: 72% for medications (of which 51% for modulator therapies), 15% for hospital stays, 7% for medical visits, 3% for indirect costs, 2% for medical devices, 1% for outpatient medical procedures.
There was a strong increase in the mean annual cost per CF patient between 2006 and 2017, mostly due to the cost of therapy after the introduction of cystic fibrosis transmembrane conductance regulator (CFTR) modulators. The combination of an increase in the number of CF patients - particularly adult patients - and an increase in the annual cost per patient led to a substantial increase in the total cost of CF disease care for the health systems.
对囊性纤维化（CF）自然病程的深入了解导致了治疗方法的改进，这些方法改善了肺部健康状况并延长了受影响个体的预期寿命。本研究评估了改良人口统计学数据和 CF 管理变化如何影响资源消耗和护理成本。
从法国 CF 注册处的 2006 年至 2016 年的 CF 患者的病历中提取数据，并与他们相应的索赔数据（SNDS）进行关联。从 2006 年至 2017 年，按日历年度对药物、就诊、程序、住院和间接成本进行年化。
在纳入法国 CF 注册处的 7671 名患者中，有 6187 名患者（51.9%为男性，平均年龄为 24.7 岁）与 SNDS 相关联。2006 年每位患者的平均费用为 14174 欧元，2011 年为 21920 欧元，2017 年为 44585 欧元。与住院相关的费用从 2006 年每位患者 3843 欧元增加到 2017 年的 6741 欧元。2017 年，每位 CF 患者的平均费用分配如下：72%用于药物（其中 51%用于调节剂治疗），15%用于住院，7%用于就诊，3%用于间接费用，2%用于医疗设备，1%用于门诊医疗程序。
2006 年至 2017 年，每位 CF 患者的平均年度费用呈强劲增长，主要是由于 CF 跨膜电导调节剂（CFTR）调节剂引入后治疗费用的增加。CF 患者数量的增加（尤其是成年患者）和每位患者的年度费用的增加，导致卫生系统 CF 疾病护理总成本的大幅增加。
