OBJECTIVES: To estimate the resource use and direct health care cost of progressive pulmonary fibrosis (PPF) non-IPF in Spain

METHODS: A two-round Delphi panel of 28 experts, specialist in pulmonology (61%), rheumatology (21%) and internal medicine (18%), was carried out between January and December 2020. The resources evaluated were the median number of medical visits, laboratory tests and imaging tests performed: at diagnosis, during disease follow-up, and for the management of exacerbations. The direct costs, expressed as average and interquartile range, were calculated by multiplying the median number of each resource by the corresponding unit cost, obtained from the eSalud Spanish database.

RESULTS: According to the Delphi panel, for the diagnosis of the PPF, at least, an average of 3 visits to the pulmonologist and 2 visits to rheumatologist/internist are necessary, for the follow-up 2 visits to pulmonology, rheumatology and nursing and for the management of an exacerbation up to 3 visits to pulmonology. During diagnosis, patients undergo numerous laboratory tests (complete blood count, urine test and/or liver profile, frequently) which increase during the follow-up. In addition, these patients undergo 2 spirometry tests and 1 chest X-ray and HRCT in a period of one year. During the course of the disease, on average, these patients require an annual hospital admission of 8 days in the pulmonology department, which increases to 11 days and the possibility of an ICU admission in case of acute exacerbation. The estimated average annual cost is €4,955.9 (€2,890.4-€5,815.1) for diagnosis, €7,421.6 (€4,135.4-€12,098.7) for follow-up and €20,556.5 (€4,233.8-€29,683.9) for the management of acute exacerbations.

CONCLUSIONS: The opinion of the expert panel highlights the high economic impact associated with the disease, mainly due to management of exacerbation. The average cost per patient amounts to €32,934.0 per year, in accordance with the estimated cost in patients with IPF (€26,435 per year)¹.