title: Economic Burden And Health-Related Quality Of Life Of Patients With Cystic Fibrosis In Bulgaria.
abstract: The aim of this study was to determine the economic burden from a societal perspective and health-related quality of life (HRQOL) of patients with cystic fibrosis (CF) in Bulgaria.
  
  
  
  We conducted a cross-sectional study of 33 patients with CF and 17 caregivers from Bulgaria. Data on socio-demographic characteristics, health resource utilisation, informal care, labor productivity losses and HRQOL were collected from questionnaires completed by patients or their caregivers. HRQOL was evaluated with the EuroQol 5-domain (EQ-5D-3L) questionnaire.
  
  
  
  Median annual costs of CF in Bulgaria were € 24 152 per patient in 2012 as a reference year. Median annual costs for children were found to be significantly higher than those for adults - € 31 945 vs. € 15 714 (p = 0.012). This outcome came from statistically significant differences in costs for main informal carer (p < 0.001) and costs for other informal carers (p = 0.022). As a single cost item, drugs had the biggest monetary impact. Median annual drug costs were € 13 059. Bulgarian CF patients showed low HRQOL results - 50 median VAS score and 0.592 median health utilities. A quarter of patients even rated their health state as worse than death.
  
  
  
  CF patients from Eastern Europe remain a vulnerable population with risk factors for worse health outcomes. Our study provided a state-of-the art analysis that facilitates the elaboration, adoption and application of targeted public health policies to tackle CF-related problems at national and European level.
authors.forename: Georgi G
authors.initials: GG
authors.lastname: Iskrov
authors.affiliation: Department of Social Medicine and Public Health, Faculty of Public Health, Medical University, Plovdiv, Bulgaria|Institute for Rare Diseases, Plovdiv, Bulgaria
authors.forename: Rumen S
authors.initials: RS
authors.lastname: Stefanov
authors.affiliation: University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain|Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Spain
authors.forename: Julio
authors.initials: J
authors.lastname: López-Bastida
authors.affiliation: Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Spain|Fundación Canaria de Investigación Sanitaria (FUNCANIS), Spain
authors.forename: Renata
authors.initials: R
authors.lastname: Linertová
authors.affiliation: Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Spain|University of Castilla-La Mancha, Toledo, Spain
authors.forename: Juan
authors.initials: J
authors.lastname: Oliva-Moreno
authors.affiliation: Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Spain|Evaluation and Planning Service at Canary Islands Health Service (SESCS), Santa Cruz de Tenerife, Spain
authors.forename: Pedro
authors.initials: P
authors.lastname: Serrano-Aguilar
mesh_terms: D000293:Adolescent; D000328:Adult; D002031:Bulgaria; D002648:Child; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000191:economics / Q000523:psychology*; D016527:Drug Costs; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life