Background:

Cystic fibrosis (CF) is the most serious and frequent hereditary autosomal disease that causes respiratory, hepatic and pancreatic dysfunction. The aim of the study was to assess the pharmaceutical and medical cost in CF outpatients from the Adult Cystic Fibrosis Unit at third level hospital.

Material and methods:

Retrospective observational study in adult CF patients throughout the year 2017. Demographic and clinical variables were included. All of the medical variables considered were directly related to the disease. Considered cost were laboratory selling price notified in Nomenclator. Medical costs were calculated based on laboratory's price list and hospital medical procedures.

Results:

89 CF patients enter the study, and 57 patients were finally included. The mean age was 32.5 years, 56.1% were female. 36.5% patients were homozygous for Phe508del, 40.4% heterozygous, and 22.8% had another mutation. The average FEV1 was 72.2%. 33.3% patients were colonized by sensitive Pseudomonas aeruginosa (PA) and 7.0% by multidrug-resistant PA. Total costs per year was EUR 623,981.3, (87.6% drug costs and 12.4% medical costs).

Medical, drug and total costs were higher in Phe508del/Phe508del mutation group than Phe508del/other and other/other (p<0.05). Microbial colonization increased costs (p<0.05); colonized by sensitive PA had statistically significant higher drug and total costs, similar in multidrug resistant PA. Medical costs increase with severity level of lung function (p=0.001), also drug and total costs with the exception of severe patients.

Conclusion:

CF is a relative costly disease for the healthcare system. In our study homozygous Phe508del mutation patients, lows values of FEV1 and colonization had higher cost.

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