Abstract

Background: There is sparse evidence on the economic burden associated with Interstitial Lung Diseases (ILDs) and the interaction between healthcare domains, especially on the level of distinct ILD-subtypes. To close this knowledge gap we performed a longitudinal analysis of costs of care for individuals with different ILDs.

Methods: We identified 37,489 patients with newly diagnosed ILD—mostly IPF-related syndrome, sarcoidosis, and fibrosing ILDs—between 2010 and 2012 based on ICD-10 codes from a German statutory health insurance fund insuring ~21.7 million adults. Then, we assessed total healthcare spending and spending for the distinct service domains one year prior diagnosis and up to five years after.

Results: Mean per capita spending doubled in the year of diagnosis (€12,763 vs. €6,361 previous year) and declined afterwards almost to the pre-diagnosis level. Inpatient care accounted for 71.5% of spending in the year of diagnosis but only for ~50% in the post-diagnosis period. Medication and outpatient physician care accounted for ~28% and ~15% in the years post diagnosis. Cost compilation and trends were similar for the distinct ILD-subtypes, but absolute amounts differed substantially. Compared to IPF-related syndrome (Ø=€13,750) or medication-associated ILDs (Ø=€17,416), spending in the year of diagnosis was low for individuals with sarcoidosis (Ø=€8,199).

Conclusion: Costs for ILD-patients are particularly high in the initial phase, reflecting the long and mostly inpatient process of complex diagnosis. More detailed analyses on the underlying healthcare utilization patterns on the substance and procedure level will support sound understanding of current care structures and therewith associated economic burden.