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

Abstract

<div>Aim of the study: Potential care implications of antifibrotic reimbursement restrictions were</div><div>studied by forced vital capacity (FVC) decline, mortality and specialty care related healthcare</div><div>resource utilization in patients with idiopathic pulmonary fibrosis (IPF).</div><div>Material and methods: IPF patients were identified from the electronic medical records of the</div><div>Hospital District of Southwest Finland between 2005 and 2017. Text-mining was used for patient</div><div>identification to exclude other interstitial lung diseases (ILD) from the cohort. FVC reimbursement</div><div>restriction (FVC 50-90%) was used for stratification.</div><div>Results: Out of all patients with ILD, 27% (N = 266) were identified to have IPF. At baseline, 24%</div><div>presented with FVC>90% and 63% with FVC 50-90% predicted. FVC at diagnosis did not improve</div><div>during the study period. Median survival decreased by severity from 6.7 years in FVC>90% at</div><div>baseline to 0.7 years in patient with FVC<50% predicted. In the FVC>90% group, 14% died before</div><div>a change in FVC category could be noted. Overall, 4.7 million euro worth of specialty care</div><div>resources were spent on IPF patients. The highest cost driver was inpatient days.</div><div>Conclusions: IPF is associated with a high burden of disease, and reimbursement restrictions are</div><div>in conflict with early care. As there are antifibrotic treatment options for IPF patients, early diagnosis is important.</div>