title: Treatment patterns, resource use and costs of idiopathic pulmonary fibrosis in Spain--results of a Delphi Panel.
abstract: BACKGROUND
  Idiopathic pulmonary fibrosis (IPF) is a form of chronic fibrosing interstitial pneumonia characterized by progressive worsening of dyspnea and lung function, with a poor prognosis. The objective of this study was to determine treatment patterns, resource use and costs of managing Spanish patients with IPF.
  
  
  METHODS
  A three-round Delphi consensus panel of 15 clinical experts was held between December 2012 and June 2013 using questionnaires to describe the management of patients with IPF. A cost analysis based on Delphi panel estimates was made from the Spanish National Health System (NHS) perspective, including the direct costs of IPF diagnosis and management. Unit costs were applied to Delphi panel estimates of health resource use. Univariate sensitivity analyses were made to evaluate uncertainties in parameters.
  
  
  RESULTS
  The Delphi panel estimated that 20, 60 and 20% of IPF patients presented with stable disease, slow and rapid disease progression, respectively. The estimated annual cost per patient with stable disease, slow and rapid disease progression was €11,484, €20,978 and €57,759, respectively. This corresponds to a weighted average annual cost of €26,435 with itemized costs of €1,184 (4.5), €7,147 (27.0), €5,950 (22.5), €11,666 (44.1) and €488 (1.9%) for the diagnosis of IPF, treatment, monitoring, management of acute exacerbations and end-of-life care, respectively. The parameter that varied the annual cost per patient the most was resource use associated with acute exacerbations.
  
  
  CONCLUSIONS
  The management of patients with IPF in Spain, especially patients with rapid disease progression, has a high economic impact on the NHS.
authors.affiliation: Vall d´Hebron Institut de Recerca (VHIR), Respiratory Department, Hospital Universitari Vall d´Hebron and CIBER in Respiratory Diseases, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Morell
authors.affiliation: Boehringer Ingelheim, Binger Str. 173, 55216, Ingelheim am Rhein, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Esser
authors.affiliation: Boehringer Ingelheim, Binger Str. 173, 55216, Ingelheim am Rhein, Germany.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lim
authors.affiliation: Boehringer Ingelheim, Binger Str. 173, 55216, Ingelheim am Rhein, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Stowasser
authors.affiliation: Oblikue Consulting S.L., Avenida Diagonal 514, 3°-3a, 08006, Barcelona, Spain. alba.villacampa@oblikue.com.
authors.forename: Alba
authors.initials: A
authors.lastname: Villacampa
authors.affiliation: Oblikue Consulting S.L., Avenida Diagonal 514, 3°-3a, 08006, Barcelona, Spain.
authors.forename: Diana
authors.initials: D
authors.lastname: Nieves
authors.affiliation: Oblikue Consulting S.L., Avenida Diagonal 514, 3°-3a, 08006, Barcelona, Spain.
authors.forename: Max
authors.initials: M
authors.lastname: Brosa
mesh_terms: D003365:Costs and Cost Analysis; D003697:Delphi Technique; D018450:Disease Progression; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data*; D015272:Pulmonary Medicine; D013030:Spain; D013222:State Medicine / Q000191:economics