Presentation (CTI)

OBJECTIVES: Non-cystic fibrosis bronchiectasis (NCFB) is a long-term respiratory disease with heterogeneous characteristics. The Institute for Clinical and Economic Review recently assessed the value of a newly approved first-in-class agent for NCFB, highlighting the current evidence gap in economic outcomes of NCFB. This study aims to update real-world cost data on the treatment management of US NCFB patients using a recent healthcare claims database.
METHODS: This retrospective observational study used the MarketScan Commercial Encounters and Claims and Medicare Supplemental databases from 2016 - 2024. The study cohort consisted of patients newly diagnosed with NCFB (Index date), defined by one inpatient or two or more outpatient claims for bronchiectasis. Selected individuals were naïve to NCFB for at least 12 months prior to the index and were free from cystic fibrosis throughout the data enrollment. All-cause per-patient-per-month (PPPM) healthcare costs were calculated using the reimbursed amounts adjudicated from medical and pharmacy claims for patients continuously enrolled in the data for at least 6 months following the index date.
RESULTS: The analytic cohort consisted of 40,960 NCFB patients with a mean (SD) age of 64.42 (14.52) years; 60.18% were female. The mean (SD) PPPM total costs were $5,151 (13,012), with a median PPPM cost of $1,687 in 2025 USD. Healthcare costs for NCFB patients were driven by medical-sector costs, with mean (SD) PPPM medical costs of $4,279 (12,295) and pharmacy costs of $873 (2,770).
CONCLUSIONS: Patients diagnosed with NCFB incurred substantial healthcare costs to payers. The distribution of total healthcare costs was right-skewed and heavy-tailed, indicating that overall spending would be driven by a small subset of patients necessitating costly medical care. Updates on real-world evidence are recommended to support payer and administrative decision-making in managing NCFB treatment expenditures.