OBJECTIVES: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal lung disease associated with dyspnoea, cough and impaired quality of life affecting 7,700 patients in Spain. Our aim was to estimate and compare the economic impact of IPF according to forced vital capacity (FVC) % predicted level in adult patients through estimation of annual direct and indirect costs.

METHODS: Prospective, observational, multicentric study of patients with confirmed IPF. Annual IPF-associated costs included direct costs (primary and secondary care visits, outpatient visits, emergency visits...) and indirect costs (days off work and informal caregiver).

RESULTS: 204 consecutive IPF patients were included: 77% male, average age (SD) 70.8 (7.6) years. At baseline, FVC was <50%, 50–80% and >80% in 10.8%, 74.5% and 14.7% of patients, respectively. The mean (SD) total annual IPF-related costs was 23,661.21 (15,385.65) €, with statistically significant differences (p=0.0002) between groups: 38,923.57 (29,263.42) € for the FVC<50% group, 22,613.68 (12,873.07) € for the FVC 50-80% group and 20,369.94 (11,955.91) € for the FVC>80% group. Also, statistically significant differences were observed among FVC% predicted groups in the annual direct and annual non-direct costs (p=0.0007 and p<0.0001, respectively). Annual direct health IPF-related costs had the greatest weight. It included pharmacological treatments (mean (SD): 19,565.11 (12,070.96) €) and hospitalization-days (mean (SD): 1,453.57 (6,452.10) €). Higher costs were observed in patients with lower FVC%, significatively in primary and secondary care visits, hospitalization-days, hospitalizations-ICU and non-pharmacological treatments costs. Regarding indirect costs, the annual mean (SD) cost for informal caregiver was 37.07 (293.59) €, with no differences between FVC% predicted groups (p=0.6339).

CONCLUSIONS: We observed a significantly higher annual IPF-related cost at a lower level of predicted FVC%, the direct cost having the greatest weight to the total costs. Maintaining patients at early disease stages by slowing IPF progression is relevant to reduce the economic impact of IPF.