OBJECTIVES: To estimate the direct cystic fibrosis treatment costs from the perspective of a health insurance company in Brazil.

METHODS: Retrospective observational study. Data obtained from the Unimed Campinas Health Plan, in the period from October/2021 to September/2022. From a portfolio of 550,000 customers, those with cystic fibrosis in ICD-10 (E84) were selected. Direct costs included the values of home and ambulatory care, emergency care and hospitalizations, consultations, exams and drugs.

RESULTS: 130 individuals were included, 53 males (median age 19 years) and 77 females (median age 44 years). The annual direct cost was US$55,519.47, with per capita cost of US$427,07. Home and ambulatory care represented the highest value, totaling 52.3%, followed by emergency care and hospitalizations, consultations, exams and drugs, respectively 24.7%, 12.5%, 6.8% and 3.7%. Among the home and ambulatory care costs, home care represented 99.4% and home oxygen therapy 15.9% of this amount. In emergency care and hospitalizations, 29.5% was spent on daily rates in the intensive care unit (ICU), followed by 16% in shared rooms and 14.9% in isolation. 29.4% of the consultations happened in emergency rooms. Regarding costs with exams, 26% were used for chest computed tomography and 17% for complete pulmonary function test. Beholding drugs, the value used in antibiotics stands out, 94%.

CONCLUSIONS: The data demonstrated a significant economic impact on the cystic fibrosis treatment in private health care, in which the highest costs were directed to home care, emergency care and hospitalizations. Therefore, the importance of patient care in order to reduce complications and costs associated with the aggravation of the disease is emphasized. In Brazil there are health care reference centers with drugs supply at the public level, so the data may not reflect the disease’s full costs for these individuals.