Forced Vital Capacity (FVC) decline, mortality and healthcare resource utilization in idiopathic pulmonary fibrosis

: Mariann I. Lassenius, Iiro Toppila, Nora Pöntynen, Laura Kasslin, Jaana Kaunisto, Maritta Kilpeläinen, Tarja Laitinen

: 2020

: European Clinical Respiratory Journal

: European clinical respiratory journal

: Eur Clin Respir J

: 7

: 1

: 2001-8525

DOI: https://doi.org/10.1080/20018525.2019.1702618

: 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.

Forced Vital Capacity FVC decline mortality and healthcare resource utilization in idiopathic pulmonary fibrosis.pdf