Evolution of costs of care for cystic fibrosis patients after clinical guidelines implementation in a French network.
OBJECTIVE
The aim of this study was to evaluate how advances in CF management in France between 2000 and 2003 impacted CF-related costs.


METHODS
The analysis of direct medical costs was done in 2000 and 2003 from the perspective of the French national healthcare insurance system. The patients, 65 in 2000 and 64 in 2003, were followed-up in one pediatric and one adult CF reference center (CFRC). We quantified and valued CF-related home and hospital care costs.


RESULTS
We found an average cost of euro16474/patient/year in 2000, and euro22725 in 2003 (based on the 2003 euro value). Hospital care increased from 15% of the total cost in 2000 to 22% in 2003. Medications accounted for 45% of the total cost for the two periods, with an average cost of euro7229/patient/year in 2000 and euro10336 in 2003. Home intravenous antibiotic therapy accounted for 20% of the total cost for the two periods.


CONCLUSIONS
We highlighted an increase in CF care costs between 2000 and 2003, which might be related to the changes in practice patterns that followed guidelines implementation, such as the use of new medications (dornase alpha and tobramycin) and more frequent follow-up in the CFRC.
Huot
Laure
L
Hospices Civils de Lyon, Pôle Information Médicale Recherche Evaluation, Lyon, F-69003 France. laure.huot@chu-lyon.fr
Durieu
Isabelle
I
Bourdy
Stéphanie
S
Ganne
Christell
C
Bellon
Gabriel
G
Colin
Cyrille
C
Touzet
Sandrine
S
D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D003550:Cystic Fibrosis / Q000191:economics* / Q000628:therapy*; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000191:economics*; D006699:Home Care Services / Q000191:economics; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D017410:Practice Guidelines as Topic; D018709:Statistics, Nonparametric