title: Cost-of-illness analysis and regression modeling in cystic fibrosis: a retrospective prevalence-based study.
abstract: BACKGROUND
  Economic data pertaining to cystic fibrosis (CF), is limited in Europe generally, and completely lacking in Central and Eastern Europe. We performed an analysis of all direct costs associated with CF relative to key disease features and laboratory examinations.
  
  
  METHODS
  A retrospective prevalence-based cost-of-illness (COI) study was performed in a representative cohort of 242 CF patients in the Czech Republic, which represents about 65 % of all Czech CF patients. Medical records and invoices to health insurance companies for reference year 2010 were analyzed.
  
  
  RESULTS
  The mean total health care costs were €14,486 per patient, with the majority of the costs going towards medicinal products and devices (€10,321). Medical procedures (€2676) and inpatient care (€1829) represented a much smaller percentage of costs. A generalized linear model showed that the strongest cost drivers, for all cost categories, were associated with patient age and lung disease severity (assessed using the FEV1 spirometric parameter), when compounded by chronic Pseudomonas aeruginosa airway infections. Specifically, maximum total costs are around the age 16 years; a FEV1 increase of 1 % point represented a cost decrease of: 0.9 % (medicinal products), 1.7 % (total costs), 2.8 % (procedures) and 7.0 % (inpatient care).
  
  
  CONCLUSIONS
  COI analysis and regression modeling using the most recent data available can provide a better understanding of the overall economic CF burden. A comparison of our results with other methodologically similar studies demonstrates that although overall costs may differ, FEV1 can nonetheless be utilized as a generally transferrable indicator of the relative economic impact of CF.
authors.affiliation: Institute of Health Economics and Technological Assessment, Prague, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Mlčoch
authors.affiliation: Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University in Prague, Prague, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Klimeš
authors.affiliation: Department of Pneumology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
authors.forename: Libor
authors.initials: L
authors.lastname: Fila
authors.affiliation: Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
authors.forename: Věra
authors.initials: V
authors.lastname: Vávrová
authors.affiliation: Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
authors.forename: Veronika
authors.initials: V
authors.lastname: Skalická
authors.affiliation: Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Úvalu 84, 15006, Prague 5, Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Turnovec
authors.affiliation: Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Úvalu 84, 15006, Prague 5, Czech Republic.
authors.forename: Veronika
authors.initials: V
authors.lastname: Krulišová
authors.affiliation: Institute of Health Economics and Technological Assessment, Prague, Czech Republic.
authors.forename: Jitka
authors.initials: J
authors.lastname: Jirčíková
authors.affiliation: Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
authors.forename: Dana
authors.initials: D
authors.lastname: Zemková
authors.affiliation: Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
authors.forename: Klára Vilimovská
authors.initials: KV
authors.lastname: Dědečková
authors.affiliation: Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
authors.forename: Alena
authors.initials: A
authors.lastname: Bílková
authors.affiliation: Division of Health Insurance, University Hospital Motol, Prague, Czech Republic.
authors.forename: Vladimíra
authors.initials: V
authors.lastname: Frühaufová
authors.affiliation: Department of Children's Infectious Diseases, Faculty of Medicine of Masaryk University, University Hospital, Brno, Czech Republic.
authors.forename: Lukáš
authors.initials: L
authors.lastname: Homola
authors.affiliation: Division of Health Insurance, University Hospital Motol, Prague, Czech Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Friedmannová
authors.affiliation: Division of Health Insurance, University Hospital Motol, Prague, Czech Republic.
authors.forename: Radovan
authors.initials: R
authors.lastname: Drnek
authors.affiliation: Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Dřevínek
authors.affiliation: Institute of Health Economics and Technological Assessment, Prague, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Doležal
authors.affiliation: Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Úvalu 84, 15006, Prague 5, Czech Republic. Milan.Macek.Jr@LFmotol.cuni.cz.
authors.forename: Milan
authors.initials: M
authors.lastname: Macek
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003550:Cystic Fibrosis / Q000191:economics* / Q000453:epidemiology / Q000503:physiopathology; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D011552:Pseudomonas Infections / Q000191:economics / Q000453:epidemiology; D012044:Regression Analysis; D012189:Retrospective Studies; D013147:Spirometry
keywords: Cost-of-illness; Cystic fibrosis; Disease severity; FEV1; Generalized linear model; Health care costs