Real-World Healthcare Resource Utilization and Economic Burden Associated With Progressive Pulmonary Fibrosis in Commercially Insured and Medicare Advantage Populations in the United States
Author(s)
Joseph S. Yang, PharmD, MS1, Bonnie Bui, PhD2, Timothy Bancroft, PhD2, Rebecca Fee, MPH2, Andrea Steffens, MPH2, Bijan J. Borah, MSc, PhD3;
1Boehringer Ingelheim, HEOR Value Demonstration Team, Ridgefield, CT, USA, 2Optum Life Sciences, Eden Prairie, MN, USA, 3Mayo Clinic, Rochester, MN, USA
1Boehringer Ingelheim, HEOR Value Demonstration Team, Ridgefield, CT, USA, 2Optum Life Sciences, Eden Prairie, MN, USA, 3Mayo Clinic, Rochester, MN, USA
Presentation Documents
OBJECTIVES: Fibrosing interstitial lung disease (ILD) that progresses is known as progressive pulmonary fibrosis (PPF). Previous studies have estimated economic burden associated with PPF. However, evidence is limited on burden by insurance type. This study estimated healthcare resource utilization (HCRU) and costs among patients with PPF by payer type (commercial and Medicare Advantage Prescription Drug plans [MAPD]).
METHODS: Patients ≥18 years and newly diagnosed with fibrosing ILD, defined as ≥2 fibrosing ILD diagnoses on separate dates within 365 days from January 2017 to November 2023, were identified from Optum Research Database. Then, patients with evidence of progression, identified using claims-based proxy measures, were 1:1 propensity score matched to not-yet-progressed patients based on covariates measured before fibrosing ILD diagnosis. Patients were continuously enrolled for 12 months before fibrosing ILD diagnosis date (baseline) and ≥3 months after index date. Post-match weighted per-patient-per-month (wPPPM) all-cause and fibrosing-ILD HCRU and costs (plan + patient-paid amounts) were compared between progressive vs not-yet-progressed cohorts within insurance type.
RESULTS: 60,171 progressive patients were matched with 60,171 not-yet-progressed patients (commercial: 9,488 pairs; MAPD: 50,683 pairs). Post-match baseline variables were well-balanced for both payer types. Progressive patients had higher mean (SD) total all-cause wPPPM costs vs not-yet-progressed patients (commercial: $6,164 [$13,954] vs $2,741 [$6,630], p<0.001; MAPD: $3,640 [$5,057] vs $1,897 [$3,090], p<0.001). Total costs for progressive patients were primarily driven by medical costs, with hospitalization constituting 42% and 50% of medical costs for commercial and MAPD patients, respectively. Overall, costs were numerically higher among commercial patients than MAPD patients. The mean (SD) wPPPM number of hospitalizations was over two times higher among progressive vs not-yet-progressed patients (commercial: 0.05 [0.10] vs 0.02 [0.07], p<0.001; MAPD: 0.07 [0.11] vs 0.03 [0.07], p<0.001).
CONCLUSIONS: Patients with PPF had substantially higher HCRU and cost burden relative to not-yet-progressed patients in both payer types.
METHODS: Patients ≥18 years and newly diagnosed with fibrosing ILD, defined as ≥2 fibrosing ILD diagnoses on separate dates within 365 days from January 2017 to November 2023, were identified from Optum Research Database. Then, patients with evidence of progression, identified using claims-based proxy measures, were 1:1 propensity score matched to not-yet-progressed patients based on covariates measured before fibrosing ILD diagnosis. Patients were continuously enrolled for 12 months before fibrosing ILD diagnosis date (baseline) and ≥3 months after index date. Post-match weighted per-patient-per-month (wPPPM) all-cause and fibrosing-ILD HCRU and costs (plan + patient-paid amounts) were compared between progressive vs not-yet-progressed cohorts within insurance type.
RESULTS: 60,171 progressive patients were matched with 60,171 not-yet-progressed patients (commercial: 9,488 pairs; MAPD: 50,683 pairs). Post-match baseline variables were well-balanced for both payer types. Progressive patients had higher mean (SD) total all-cause wPPPM costs vs not-yet-progressed patients (commercial: $6,164 [$13,954] vs $2,741 [$6,630], p<0.001; MAPD: $3,640 [$5,057] vs $1,897 [$3,090], p<0.001). Total costs for progressive patients were primarily driven by medical costs, with hospitalization constituting 42% and 50% of medical costs for commercial and MAPD patients, respectively. Overall, costs were numerically higher among commercial patients than MAPD patients. The mean (SD) wPPPM number of hospitalizations was over two times higher among progressive vs not-yet-progressed patients (commercial: 0.05 [0.10] vs 0.02 [0.07], p<0.001; MAPD: 0.07 [0.11] vs 0.03 [0.07], p<0.001).
CONCLUSIONS: Patients with PPF had substantially higher HCRU and cost burden relative to not-yet-progressed patients in both payer types.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE365
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)