Department of Medicine, University of British Columbia, Vancouver, Canada.
Centre for Heart Lung Innovation, St. Paul's Hospital, Ward 8B - Providence Wing, 1081 Burrard St., Vancouver, V6Z 1Y6, Canada.
BMC Pulm Med. 2022 Apr 20;22(1):148. doi: 10.1186/s12890-022-01922-2.
The economic burden of interstitial lung disease (ILD) is unknown, limiting informed resource allocation and planning. We sought to conduct the first systematic review on the direct, indirect, and overall costs associated with ILD and to evaluate the cost-effectiveness of current therapies globally.
We conducted systematic reviews of ILD disease cost studies and cost-effectiveness analyses (CEAs) using MEDLINE, Embase, and Web of Science databases between 2000 and 2020. We compared ILD costs between countries according to the share of costs towards each country's respective gross domestic product (GDP) per capita. Costs are reported in 2020 USD.
We identified 25 disease cost studies and 7 CEAs. The direct medical costs ranged between $1824 and $116,927 annually per patient (median $32,834; 14-180% of GDP per capita in Western countries). The leading drivers of direct costs were inpatient (55%), outpatient (22%), and medication costs (18%), based on pooled estimates. Annual indirect costs ranged from $7149 to $10,902 per employed patient (median $9607; 12-23% of GDP per capita). Among the 7 CEAs, only 1 study (14%) showed an ILD therapy (ambulatory oxygen) was cost-effective compared to best supportive care.
The direct and indirect costs associated with ILD are consistently high in all countries with available data, with cost-effectiveness profiles of new therapies generally undesirable. Globally, the median total direct cost for ILD equates to 51% of a country's GDP per capita and has been increasing over time.
间质性肺病（ILD）的经济负担尚不清楚，这限制了资源的合理配置和规划。我们旨在对ILD 相关直接、间接和总体成本进行首次系统综述，并评估全球现有疗法的成本效益。
我们对 2000 年至 2020 年间 MEDLINE、Embase 和 Web of Science 数据库中的ILD 疾病成本研究和成本效益分析（CEA）进行了系统评价。我们根据各国人均国内生产总值（GDP）占总成本的比例，比较了各国之间的ILD 成本。成本以 2020 年美元计。
我们确定了 25 项疾病成本研究和 7 项 CEA。每位患者的直接医疗费用每年在 1824 美元至 116927 美元之间（中位数为 32834 美元；西方国家为 14%至 180%的人均 GDP）。根据汇总估计，直接成本的主要驱动因素是住院（55%）、门诊（22%）和药物治疗（18%）。每年每位在职患者的间接费用在 7149 美元至 10902 美元之间（中位数为 9607 美元；占人均 GDP 的 12%至 23%）。在 7 项 CEA 中，只有 1 项研究（14%）显示ILD 治疗（门诊吸氧）与最佳支持性护理相比具有成本效益。
在所有有数据的国家，ILD 相关的直接和间接成本都很高，新疗法的成本效益概况通常不理想。全球ILD 的直接总成本中位数相当于人均 GDP 的 51%，且呈上升趋势。
