(348) Real-world healthcare resource utilization and economic burden associated with progressive pulmonary fibrosis in commercially insured and Medicare Advantage Populations in the United States

Background: : Fibrosing interstitial lung disease (ILD) that progresses is known as progressive pulmonary fibrosis (PPF). Previous studies have estimated economic burden associated with PPF. However, evidence is limited on burden by insurance type.

Objective: : This study estimated healthcare resource utilization (HCRU) and costs among patients with PPF by payer type (commercial and Medicare Advantage Prescription Drug plans [MAPD]).

Methods: : Patients ≥18 years and newly diagnosed with fibrosing ILD, defined as ≥2 fibrosing ILD diagnoses on separate dates within 365 days from January 2017 to November 2023, were identified from Optum Research Database. Then, patients with evidence of progression, identified using claims-based proxy measures, were 1:1 propensity score matched to not-yet-progressed patients based on covariates measured before fibrosing ILD diagnosis. Patients were continuously enrolled for 12 months before fibrosing ILD diagnosis date (baseline) and ≥3 months after index date. Post-match weighted per-patient-per-month (wPPPM) all-cause and fibrosing-ILD HCRU and costs were compared between progressive vs not-yet-progressed cohorts within insurance type.

Results: : 60,171 progressive patients were matched with 60,171 not-yet-progressed patients (commercial: 9,488 pairs; MAPD: 50,683 pairs), with well-balanced baseline characteristic post-match for both payer types. Progressive patients incurred higher mean (SD) total all-cause wPPPM costs vs not-yet-progressed patients (commercial: $6,164 [$13,954] vs $2,741 [$6,630], p< 0.001; MAPD: $3,640 [$5,057] vs $1,897 [$3,090]; p< 0.001). Hospitalizations were the primary cost drivers of medical costs among progressive patients, accounting for 42% (commercial) and 50% (MAPD). Overall, costs were numerically higher in patients enrolled in commercial insurance compared to patients enrolled in MAPD. Progressive patients had higher HCRU across all categories compared to not-yet progressed patients in both insurance types. The mean (SD) wPPPM number of hospitalizations was over two times higher among progressive vs not-yet-progressed patients (commercial: 0.05 [0.10] vs 0.02 [0.07], p< 0.001; MAPD: 0.07 [0.11] vs 0.03 [0.07], p< 0.001).

Conclusions: : Patients with fibrosing ILD who progressed had substantially higher HCRU and cost burden relative to not-yet-progressed patients in both payer types, highlighting the need for more effective treatment.

Sponsorship:: Boehringer Ingelheim