A1 Refereed original research article in a scientific journal
Forced Vital Capacity (FVC) decline, mortality and healthcare resource utilization in idiopathic pulmonary fibrosis
Authors: Mariann I. Lassenius, Iiro Toppila, Nora Pöntynen, Laura Kasslin, Jaana Kaunisto, Maritta Kilpeläinen, Tarja Laitinen
Publication year: 2020
Journal: European Clinical Respiratory Journal
Journal name in source: European clinical respiratory journal
Journal acronym: Eur Clin Respir J
Volume: 7
Issue: 1
ISSN: 2001-8525
eISSN: 2001-8525
DOI: https://doi.org/10.1080/20018525.2019.1702618
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/45168566
Aim of the study: Potential care implications of antifibrotic reimbursement restrictions werestudied by forced vital capacity (FVC) decline, mortality and specialty care related healthcareresource utilization in patients with idiopathic pulmonary fibrosis (IPF).Material and methods: IPF patients were identified from the electronic medical records of theHospital District of Southwest Finland between 2005 and 2017. Text-mining was used for patientidentification to exclude other interstitial lung diseases (ILD) from the cohort. FVC reimbursementrestriction (FVC 50-90%) was used for stratification.Results: Out of all patients with ILD, 27% (N = 266) were identified to have IPF. At baseline, 24%presented with FVC>90% and 63% with FVC 50-90% predicted. FVC at diagnosis did not improveduring the study period. Median survival decreased by severity from 6.7 years in FVC>90% atbaseline to 0.7 years in patient with FVC<50% predicted. In the FVC>90% group, 14% died beforea change in FVC category could be noted. Overall, 4.7 million euro worth of specialty careresources were spent on IPF patients. The highest cost driver was inpatient days.Conclusions: IPF is associated with a high burden of disease, and reimbursement restrictions arein conflict with early care. As there are antifibrotic treatment options for IPF patients, early diagnosis is important.
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