ASSOCIATIONS BETWEEN HEALTHCARE RESOURCE USE AND TREATMENT OF IDIOPATHIC PULMONARY FIBROSIS (IPF)
Author(s)
Shannon Gallagher, MPH1, Justin Fairbanks, MD1, Michael Baldwin, BSc, MBA2, Shah Alam Khan, MPH, MSPH, MD2, Yanni Fan, ScD2, Madhu Kanakapura, MD2, Andrew H. Limper, MD3.
1Mayo Clinic Platform, Mayo Clinic, Rochester, MN, USA, 2Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany, 3Division of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN, USA.
1Mayo Clinic Platform, Mayo Clinic, Rochester, MN, USA, 2Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany, 3Division of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN, USA.
OBJECTIVES: To evaluate associations between healthcare resource use (HCRU) and prescription of antifibrotic therapy in patients with IPF.
METHODS: Electronic health records from Mayo Clinic, a US healthcare delivery network, were analysed. Patients with IPF were identified based on ≥2 outpatient visits with an ICD-9-CM or ICD-10-CM diagnosis code for IPF ≥1 to 365 days apart, or ≥1 inpatient visit with an ICD-9-CM or ICD-10-CM diagnosis code for IPF, between 1 October 2017 and 31 December 2024. Using univariate Cox proportional hazard models, we evaluated associations between HCRU in the 36 months before the first diagnosis code for IPF and prescription of nintedanib or pirfenidone after the first IPF diagnosis code.
RESULTS: Among 1133 patients, in the 36 months before the first IPF diagnosis code, 62.0% had a pulmonology clinic visit, 24.4% were hospitalised, 26.3% had an emergency department visit, and 95.5% had an outpatient visit. In total 409 (36.1%) patients had a prescription for nintedanib or pirfenidone at or after their first IPF diagnosis code. Time to prescription of nintedanib/pirfenidone was shorter among patients who had a pulmonology clinic visit in the prior 36 months than in those who did not, and longer among patients who had a hospitalisation or emergency department visit than in those who did not. Hazard ratios for associations between pulmonology clinic visit, hospitalisation, or emergency department visit prior to diagnosis of IPF and prescription of nintedanib/pirfenidone after diagnosis were 1.24 (95% CI: 1.01, 1.53; p=0.04), 0.61 (0.47, 0.79; p<0.001) and 0.59 (0.46, 0.77; p<0.001), respectively. Outpatient visits prior to diagnosis of IPF were not associated with prescription of nintedanib/pirfenidone.
CONCLUSIONS: Most patients with IPF in a US healthcare network remained untreated. Substantial proportions of patients were hospitalised or had an emergency department visit prior to diagnosis, highlighting opportunities for earlier identification and treatment.
METHODS: Electronic health records from Mayo Clinic, a US healthcare delivery network, were analysed. Patients with IPF were identified based on ≥2 outpatient visits with an ICD-9-CM or ICD-10-CM diagnosis code for IPF ≥1 to 365 days apart, or ≥1 inpatient visit with an ICD-9-CM or ICD-10-CM diagnosis code for IPF, between 1 October 2017 and 31 December 2024. Using univariate Cox proportional hazard models, we evaluated associations between HCRU in the 36 months before the first diagnosis code for IPF and prescription of nintedanib or pirfenidone after the first IPF diagnosis code.
RESULTS: Among 1133 patients, in the 36 months before the first IPF diagnosis code, 62.0% had a pulmonology clinic visit, 24.4% were hospitalised, 26.3% had an emergency department visit, and 95.5% had an outpatient visit. In total 409 (36.1%) patients had a prescription for nintedanib or pirfenidone at or after their first IPF diagnosis code. Time to prescription of nintedanib/pirfenidone was shorter among patients who had a pulmonology clinic visit in the prior 36 months than in those who did not, and longer among patients who had a hospitalisation or emergency department visit than in those who did not. Hazard ratios for associations between pulmonology clinic visit, hospitalisation, or emergency department visit prior to diagnosis of IPF and prescription of nintedanib/pirfenidone after diagnosis were 1.24 (95% CI: 1.01, 1.53; p=0.04), 0.61 (0.47, 0.79; p<0.001) and 0.59 (0.46, 0.77; p<0.001), respectively. Outpatient visits prior to diagnosis of IPF were not associated with prescription of nintedanib/pirfenidone.
CONCLUSIONS: Most patients with IPF in a US healthcare network remained untreated. Substantial proportions of patients were hospitalised or had an emergency department visit prior to diagnosis, highlighting opportunities for earlier identification and treatment.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD120
Topic
Health Service Delivery & Process of Care
Disease
Rare & Orphan Diseases, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)