Health care resources utilisation and costs in patients with non-IPF progressive fibrosing interstitial lung disease

Background: Idiopathic pulmonary fibrosis (IPF) is the classic fibrosing interstitial lung disease (ILD), but it accounts for <50% of all fibrotic lung disease seen in clinical practice. Some patients with other ILDs also develop progressive pulmonary fibrosis, with worsening in respiratory symptoms and lung function and early mortality. Data on healthcare resource utilisation and costs for these patients with non-IPF progressive fibrosing ILD (PF-ILD) are limited. Aims and objectives: To assess healthcare resource use and cost in non-IPF PF-ILD. Methods: We analysed US-based medical insurance claims over 3 years (2014–2016). Patients were considered to have ILD if they had ≥2 ILD claims and ≥1 pulmonologist visit during this period. To stabilise the dataset, patients were required to have ≥1 ILD claim per year and ≥2 medical claims in each half of each year. Here, patients with PF-ILD were defined as the subset of patients with non-IPF ILD with ≥4 pulmonologist visits in 2016 or ≥3 more pulmonologist visits in 2016 than in 2014. Results: Of 2517 patients with non-IPF ILD, 15% (n=373) were considered to have PF-ILD. Mean annual medical costs associated with ILD claims (2014–2016) were $35,364 in patients with PF-ILD compared to $20,211 in the overall ILD population. As expected, patients with PF-ILD had more ILD claims in 2016 at physician offices (7.6 vs 4.2) and hospitals (10.5 vs 4.7) compared to all ILD, suggestive of more severe disease with higher overall healthcare utilisation. Conclusion: Patients with PF-ILD have higher healthcare utilisation and costs compared to other ILD patients, highlighting the need for an improved understanding and management of PF-ILD.