Impact of Pseudomonas aeruginosa on resource utilization and costs in patients with exacerbated non-cystic fibrosis bronchiectasis

J Med Econ. 2024 Jan-Dec;27(1):671-677. doi: 10.1080/13696998.2024.2340382. Epub 2024 Apr 27.

Abstract

Aims: Non-cystic fibrosis bronchiectasis (NCFB) is a chronic progressive respiratory disorder occurring at a rate ranging from 4.2 to 278.1 cases per 100,000 persons, depending on age, in the United States. For many patients with NCFB, the presence of Pseudomonas aeruginosa (PA) makes treatment more complicated and typically has worse outcomes. Management of NCFB can be challenging, warranting a better understanding of the burden of illness for NCFB, treatments applied, healthcare resources used, and subsequent treatment costs. Comparing patients diagnosed with exacerbated NCFB, with or without PA on antibiotic utilization, treatments, and healthcare resources utilization and costs was the purpose of this study.

Materials and methods: This was a retrospective cohort study of commercial claims from IQVIA's PharMetrics Plus database (January 1,2006-December 31, 2020). Study patients with a diagnosis of NCFB were stratified into two groups based on the presence or absence of PA, then followed to identify demographic characteristics, comorbid conditions, antibiotic treatment regimen prescribed, healthcare resources utilized, and costs of care.

Results: The results showed that patients with exacerbated NCFB who were PA+ had significantly more oral antibiotic fills per patient per year, more inpatient admissions with a longer length of stay, and more outpatient encounters than those who were PA-. For costs, PA+ patients also had significantly greater total healthcare costs per patient when compared to those who were PA-.

Conclusion: Exacerbated NCFB with PA+ was associated with increased antibiotic usage, greater resource utilization, and increased costs. The major contributor to the cost differences was the use of inpatient services. Treatment strategies aimed at reducing the need for inpatient treatment could lessen the disparities observed in patients with NCFB.

Keywords: I; I1; I10; I12; Non‐cystic fibrosis bronchiectasis; healthcare resource utilization.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents* / economics
  • Anti-Bacterial Agents* / therapeutic use
  • Bronchiectasis* / drug therapy
  • Bronchiectasis* / economics
  • Comorbidity
  • Female
  • Health Expenditures / statistics & numerical data
  • Health Resources* / economics
  • Health Resources* / statistics & numerical data
  • Humans
  • Insurance Claim Review
  • Length of Stay / economics
  • Male
  • Middle Aged
  • Pseudomonas Infections* / drug therapy
  • Pseudomonas Infections* / economics
  • Pseudomonas aeruginosa*
  • Retrospective Studies
  • United States

Substances

  • Anti-Bacterial Agents