[Drug treatment of cystic fibrosis - cost patterns and savings potential for outpatient treatment].

Abstract

Background and purpose: Drug treatment of cystic fibrosis (CF) is associated with significant costs. To help ensure sustainable care, this study assesses the costs associated with outpatient treatment of adult CF patients in Germany. It identifies main cost drivers, evaluates the potential for cost savings from "aut idem" substitution and presents a projection of lifelong medication costs.

Methods: The analysis is based on a complete set of prescriptions for adult CF patients from the outpatient clinic of the university hospital of Frankfurt am Main during 2007 (n = 124 patients). Annual treatment costs were calculated on the basis of the "Rote Liste", while the potential for cost savings from "aut idem" drug substitution was obtained through ABDATA Pharma Data Service.

Results: The annual outpatient drug costs for an adult patient with CF averages € 17,219 (n = 124), which increases to € 21,782 if i.v. therapies are included. With an average life expectancy at birth of 39.7 years, total lifetime drug treatment costs amount to € 824,159 (reference year 2007, inflation rate 2.7%, 3% discount rate). "Aut idem" substitution with cheaper drugs could reduce pharmaceutical expenditures by 4.1%.

Conclusion: Our results confirm the costly nature of drug treatment for CF patients, both on an annual and in particular on a lifelong basis. At the same time, the potential for cost savings through "aut idem" substitution with cheaper drugs remains limited. The added transparency around a small set of costdriving drugs, which is offered in this study, represents a solid contribution to assess treatment choices and financing options to help secure adequate yet sustainable care for CF patients.