Health care utilization and costs of idiopathic pulmonary fibrosis in U.S. Medicare beneficiaries aged 65 years and older.
BACKGROUND
Management of idiopathic pulmonary fibrosis (IPF) is resource-intensive. Because an increasing prevalence of IPF was found among the elderly in the United States, it is important to understand the economic burden associated with the disease in this population.


OBJECTIVE
To compare health care resource utilization and costs between patients with IPF and matched control subjects without IPF in Medicare, the largest U.S. payer covering the elderly.


METHODS
Administrative claims from a 5% random sample of Medicare beneficiaries (aged 65+) from years 2000 to 2011 were analyzed. Incident patients with IPF were identified on the basis of International Classification of Diseases, ninth revision, Clinical Modification diagnosis codes, with at least 1 year of enrollment before (preindex) and after (postindex) the first diagnosis (index date). Up to five beneficiaries without IPF were matched to each patient with IPF, based on age, sex, race, and region. Annual health care resource utilization and medical costs (excluding outpatient drug costs) during the preindex and postindex periods were compared between patients with IPF and matched control subjects.


RESULTS
A total of 7,855 patients with IPF were matched to 38,856 control subjects. Compared with matched control subjects during the preindex period, patients with IPF had an 82% higher risk of hospitalization (28.8 vs. 15.8%), and 72% higher total medical costs ($10,124 vs. $5,888). Compared with matched control subjects during the postindex period, patients with IPF had a 134% higher risk of hospitalization (48.7 vs. 20.8%), similar increased risk of emergency room visits (39.6 vs. 17.5%), and 134% higher total medical costs ($20,887 vs. $8,932).


CONCLUSIONS
In the U.S. Medicare population, patients with IPF incurred substantial health care resource utilization. The annual IPF-attributable medical cost to the U.S. health care system, excluding medication costs, is estimated at close to $2 billion.
1 University of California San Francisco, School of Medicine, San Francisco, California.
Harold R
HR
Collard
2 Biogen, Health Economics and Outcomes Research, Global Market Access, Cambridge, and.
Shih-Yin
SY
Chen
2 Biogen, Health Economics and Outcomes Research, Global Market Access, Cambridge, and.
Wei-Shi
WS
Yeh
3 Evidera, Retrospective Observational Studies, Lexington, Massachusetts; and.
Qian
Q
Li
3 Evidera, Retrospective Observational Studies, Lexington, Massachusetts; and.
Yuan-Chi
YC
Lee
3 Evidera, Retrospective Observational Studies, Lexington, Massachusetts; and.
Alan
A
Wang
4 University of Washington, Medical Center, Seattle, Washington.
Ganesh
G
Raghu
D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D016527:Drug Costs; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000191:economics* / Q000453:epidemiology*; D008297:Male; D006278:Medicare / Q000191:economics*; D010342:Patient Acceptance of Health Care; D014481:United States
cost of illness; Medicare; idiopathic pulmonary fibrosis