Back to Search Start Over

Health care costs in a randomized trial of antimicrobial duration among cystic fibrosis patients with pulmonary exacerbations.

Authors :
Gold LS
Hansen RN
Patrick DL
Tabah A
Heltshe SL
Flume PA
Goss CH
West NE
Sanders DB
VanDevanter DR
Kessler L
Source :
Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2022 Jul; Vol. 21 (4), pp. 594-599. Date of Electronic Publication: 2022 Mar 14.
Publication Year :
2022

Abstract

Background: The purpose of these analyses was to determine whether overall costs were reduced in cystic fibrosis (CF) patients experiencing pulmonary exacerbation (PEx) who received shorter versus longer durations of treatment.<br />Methods: Among people with CF experiencing PEx, we calculated 30-day inpatient, outpatient, emergency room, and medication costs and summed these to derive total costs in 2020 USD. Using the Kaplan-Meier sample average (KMSA) method, we calculated adjusted costs and differences in costs within two pairs of randomized groups: early robust responders (ERR) randomized to receive treatment for 10 days (ERR-10 days) or 14 days (ERR-14 days), and non-early robust responders (NERR) randomized to receive treatment for 14 days (NERR-14 days) or 21 days (NERR-21 days).<br />Results: Patients in the shorter treatment duration groups had shorter lengths of stay per hospitalization (mean ± standard deviation (SD) for ERR-10 days: 7.9 ± 3.0 days per hospitalization compared to 10.1 ± 4.2 days in ERR-14 days; for NERR-14 days: 8.7 ± 4.9 days per hospitalization compared to 9.6 ± 6.5 days in NERR-21 days). We found statistically significantly lower adjusted mean costs (95% confidence interval) among those who were randomized to receive shorter treatment durations (ERR-10 days: $60,800 ($59,150 - $62,430) vs $74,420 ($72,610 - $76,450) in ERR-14 days; NERR-14 days: $66,690 ($65,960-$67,400) versus $74,830 ($73,980-$75,650) in NERR-21 days).<br />Conclusions: Tied with earlier evidence that shorter treatment duration was not associated with worse clinical outcomes, our analyses indicate that treating with shorter antimicrobial durations can reduce costs without diminishing clinical outcomes.<br />Competing Interests: Declaration of Competing Interest Grants from the Cystic Fibrosis Foundation in part supported the salaries of LSG, RNH, DLP, AT, SLH, PAF, CHG, NEW, DBS, DRV, and LK. Grants from the NIH in part supported the salaries of SLH, PAF, and CHG. DBS received payments for committee work from the Cystic Fibrosis foundation. DBS's institution also grant support payments from Gilead Sciences and the CHEST Foundation. DBS received personal payment for participation on an advisory board for Vertex Pharmaceuticals.<br /> (Copyright © 2022. Published by Elsevier B.V.)

Details

Language :
English
ISSN :
1873-5010
Volume :
21
Issue :
4
Database :
MEDLINE
Journal :
Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
Publication Type :
Academic Journal
Accession number :
35300932
Full Text :
https://doi.org/10.1016/j.jcf.2022.03.001