Annual direct medical costs of bronchiectasis treatment

Abstract

Patients with bronchiectasis (BE) present exacerbations that increase with severity of the disease. We aimed to determine the annual cost of BE treatment according to its severity, determined by FACED score, as well as the parameters associated with higher costs. Multicentre historical cohorts study with patients from six hospitals in Spain. The costs arising during the course of a year from maintenance treatment, exacerbations, emergency visits and hospital admissions were analysed. In total, 456 patients were included (56.4% mild BE, 26.8% moderate BE and 16.9% severe BE). The mean cost was €4671.9 per patient, which increased significantly with severity. In mild BE, most of the costs were due to bronchodilators and inhaled steroids; in severe BE, most were due to exacerbations and inhaled antibiotics. Forced expiratory volume in 1 second (FEV 1 %), age, colonization by Pseudomonas aeruginosa and the number of admissions were independently related to higher costs. The highest costs were found in patients with BE associated with chronic obstructive pulmonary disease, with the most exacerbations and with chronic bronchial colonization by Pseudomonas aeruginosa (PA). In conclusion, BE patients gave rise to high annual costs, and these were doubled on each advance in severity on the FACED score. FEV 1 %, age, colonization by PA and the number of admissions were independently related to higher costs.

Brazilian consensus on non-cystic fibrosis bronchiectasis

“…Treatment costs increase with disease severity and with factors such as age, chronic Pseudomonas aeruginosa infection, exacerbations, and hospital admissions 13 . In a study conducted in Spain, the mean annual cost per patient with bronchiectasis was €4,671.00, and this value doubled with each increase in severity (as determined by the FACED score ).…”

Adult patients with bronchiectasis: clinical guideline of European Respiratory Society

“…Экономическое бремя этого заболевания аналогично таковому для ХОБЛ и увеличивается по мере утяжеления течения болезни, учащения госпитализаций, увеличения потребности в интенсивной терапии и ингаляционных антибактериальных препаратах (АБП) [25,26,30,33,34]. В настоящее время в Европе и США специфическая терапия при БЭ Рис.…”

The challenge of defining exacerbation in bronchiectasis

“…It is also just as difficult to establish the specific parameters that must be used to define an exacerbation; parameters that are usually grouped as symptoms and/or factors involving the use of health resources or a need for treatment. Nevertheless, in the case of bronchiectasis, and other respiratory diseases, exacerbations ( particularly severe exacerbations) have a demonstrable negative impact on a patient's prognosis [1][2][3][4] and entail great expense [5,6], and so their identification, and therefore their definition, is crucial to any early detection and treatment. Ideally, such a definition should present a perfect diagnostic value and, as regards bronchiectasis, be based on reproducible objective measurements linked to inflammation/bronchial infection (biomarkers) and their consequences (acute clinical symptoms).…”