ECONOMIC BURDEN OF NON-CYSTIC FIBROSIS BRONCHIECTASIS IN EUROPE: EXACERBATIONS AND IMPLICATIONS FOR DISEASE PROGRESSION
Author(s)
Alexandra M. Furber, BSc, MSc1, Cassandra Springate, PhD2, Klas Bergenheim, PhD3, Josefine Emma Persson, PhD4.
1Senior systematic reviewer, HEOR, Cardiff, United Kingdom, 2HEOR Ltd, Cardiff, United Kingdom, 3AstraZeneca, Molndal, Sweden, 4AstraZeneca, Billdal, Sweden.
1Senior systematic reviewer, HEOR, Cardiff, United Kingdom, 2HEOR Ltd, Cardiff, United Kingdom, 3AstraZeneca, Molndal, Sweden, 4AstraZeneca, Billdal, Sweden.
OBJECTIVES: Non-cystic fibrosis bronchiectasis (NCFBE) is characterised by recurrent exacerbations and progressive lung damage. This study aimed to quantify the economic burden of NCFBE, identify the main cost drivers, and assess the contribution of exacerbations.
METHODS: A targeted literature review (TLR) was conducted to identify studies reporting the economic burden of NCFBE. Searches were conducted on MEDLINE on 17 November 2025 and updated on 7 May 2026. Only studies reporting data for European countries were included, and data on costs and resource use, and exacerbation rates, were synthesised.
RESULTS: The TLR identified 22 studies, with data from 27 to 16,963 patients per study, across European countries, including three large longitudinal registries from Spain, Germany, and the UK. In specialist clinics in Spain, annual costs averaged €4,700 per patient, rising to €10,000 in severe cases; driven primarily by hospitalisations for exacerbations (estimated at €5,300 per event). Exacerbation frequency varies widely (1 to >5 per year; median 2), with 26% of patients hospitalised annually. This burden increased further after an exacerbation event: treatment costs increase significantly (p<0.05) in the 2 months after discharge compared with the equivalent period prior to admission, and patients with frequent exacerbations had up to a threefold increase in the risk of future events, perpetuating the economic strain. Consistent with these patterns, a retrospective cohort study in Italy (n = 44) demonstrated substantial economic benefits from reducing exacerbations, achieving ~60% reductions in hospitalisations and overall resource use.
CONCLUSIONS: NCFBE imposes a high economic burden, driven by exacerbations and hospitalisations. The findings of this TLR demonstrate that effective exacerbation management can meaningfully reduce this burden. This reflects a "vicious vortex" where recurrent exacerbations drive disease progression and escalating healthcare utilisation, highlighting exacerbation prevention as a critical target for both economic and clinical optimisation.
METHODS: A targeted literature review (TLR) was conducted to identify studies reporting the economic burden of NCFBE. Searches were conducted on MEDLINE on 17 November 2025 and updated on 7 May 2026. Only studies reporting data for European countries were included, and data on costs and resource use, and exacerbation rates, were synthesised.
RESULTS: The TLR identified 22 studies, with data from 27 to 16,963 patients per study, across European countries, including three large longitudinal registries from Spain, Germany, and the UK. In specialist clinics in Spain, annual costs averaged €4,700 per patient, rising to €10,000 in severe cases; driven primarily by hospitalisations for exacerbations (estimated at €5,300 per event). Exacerbation frequency varies widely (1 to >5 per year; median 2), with 26% of patients hospitalised annually. This burden increased further after an exacerbation event: treatment costs increase significantly (p<0.05) in the 2 months after discharge compared with the equivalent period prior to admission, and patients with frequent exacerbations had up to a threefold increase in the risk of future events, perpetuating the economic strain. Consistent with these patterns, a retrospective cohort study in Italy (n = 44) demonstrated substantial economic benefits from reducing exacerbations, achieving ~60% reductions in hospitalisations and overall resource use.
CONCLUSIONS: NCFBE imposes a high economic burden, driven by exacerbations and hospitalisations. The findings of this TLR demonstrate that effective exacerbation management can meaningfully reduce this burden. This reflects a "vicious vortex" where recurrent exacerbations drive disease progression and escalating healthcare utilisation, highlighting exacerbation prevention as a critical target for both economic and clinical optimisation.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE418
Topic
Clinical Outcomes, Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)