The economic burden of bronchiectasis - known and unknown

a systematic review

Pieter C. Goeminne, Francisco Hernandez, Roland Diel, Anna Filonenko, Rowena Hughes, Fabian Juelich, George M. Solomon, Alex Upton, Kamonthip Wichmann, Weiwei Xu, James D. Chalmers (Lead / Corresponding author)

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Abstract

Background: The increasing prevalence and recognition of bronchiectasis in clinical practice necessitates a better understanding of the economic disease burden to improve the management and achieve better clinical and economic outcomes. This study aimed to assess the economic burden of bronchiectasis based on a review of published literature.

Methods: A systematic literature review was conducted using MEDLINE, Embase, EconLit and Cochrane databases to identify publications (1 January 2001 to 31 December 2016) on the economic burden of bronchiectasis in adults.

Results: A total of 26 publications were identified that reported resource use and costs associated with management of bronchiectasis. Two US studies reported annual incremental costs of bronchiectasis versus matched controls of US$5681 and US$2319 per patient. Twenty-four studies reported on hospitalization rates or duration of hospitalization for patients with bronchiectasis. Mean annual hospitalization rates per patient, reported in six studies, ranged from 0.3-1.3, while mean annual age-adjusted hospitalization rates, reported in four studies, ranged from 1.8-25.7 per 100,000 population. The average duration of hospitalization, reported in 12 studies, ranged from 2 to 17 days. Eight publications reported management costs of bronchiectasis. Total annual management costs of €3515 and €4672 per patient were reported in two Spanish studies. Two US studies reported total costs of approximately US$26,000 in patients without exacerbations, increasing to US$36,00-37,000 in patients with exacerbations. Similarly, a Spanish study reported higher total annual costs for patients with > 2 exacerbations per year (€7520) compared with those without exacerbations (€3892). P. aeruginosa infection increased management costs by US$31,551 to US$56,499, as reported in two US studies, with hospitalization being the main cost driver.

Conclusions: The current literature suggests that the economic burden of bronchiectasis in society is significant. Hospitalization costs are the major driver behind these costs, especially in patients with frequent exacerbations. However, the true economic burden of bronchiectasis is likely to be underestimated because most studies were retrospective, used ICD-9-CM coding to identify patients, and often ignored outpatient burden and cost. We present a conceptual framework to facilitate a more comprehensive assessment of the true burden of bronchiectasis for individuals, healthcare systems and society.

Original languageEnglish
Article number54
Pages (from-to)1-11
Number of pages11
JournalBMC Pulmonary Medicine
Volume19
Issue number1
DOIs
Publication statusPublished - 28 Feb 2019

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Bronchiectasis
Economics
Costs and Cost Analysis
Hospitalization
Publications
Cost of Illness
International Classification of Diseases
MEDLINE
Outpatients
Retrospective Studies
Databases
Delivery of Health Care

Keywords

  • Burden of illness
  • Bronchiectasis
  • Resource use
  • Costs
  • Hospitalization
  • Economic burden

Cite this

Goeminne, P. C., Hernandez, F., Diel, R., Filonenko, A., Hughes, R., Juelich, F., ... Chalmers, J. D. (2019). The economic burden of bronchiectasis - known and unknown: a systematic review. BMC Pulmonary Medicine, 19(1), 1-11. [54]. https://doi.org/10.1186/s12890-019-0818-6
Goeminne, Pieter C. ; Hernandez, Francisco ; Diel, Roland ; Filonenko, Anna ; Hughes, Rowena ; Juelich, Fabian ; Solomon, George M. ; Upton, Alex ; Wichmann, Kamonthip ; Xu, Weiwei ; Chalmers, James D. / The economic burden of bronchiectasis - known and unknown : a systematic review. In: BMC Pulmonary Medicine. 2019 ; Vol. 19, No. 1. pp. 1-11.
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Goeminne, PC, Hernandez, F, Diel, R, Filonenko, A, Hughes, R, Juelich, F, Solomon, GM, Upton, A, Wichmann, K, Xu, W & Chalmers, JD 2019, 'The economic burden of bronchiectasis - known and unknown: a systematic review', BMC Pulmonary Medicine, vol. 19, no. 1, 54, pp. 1-11. https://doi.org/10.1186/s12890-019-0818-6

The economic burden of bronchiectasis - known and unknown : a systematic review. / Goeminne, Pieter C.; Hernandez, Francisco; Diel, Roland; Filonenko, Anna; Hughes, Rowena; Juelich, Fabian; Solomon, George M.; Upton, Alex; Wichmann, Kamonthip; Xu, Weiwei; Chalmers, James D. (Lead / Corresponding author).

In: BMC Pulmonary Medicine, Vol. 19, No. 1, 54, 28.02.2019, p. 1-11.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The economic burden of bronchiectasis - known and unknown

T2 - a systematic review

AU - Goeminne, Pieter C.

AU - Hernandez, Francisco

AU - Diel, Roland

AU - Filonenko, Anna

AU - Hughes, Rowena

AU - Juelich, Fabian

AU - Solomon, George M.

AU - Upton, Alex

AU - Wichmann, Kamonthip

AU - Xu, Weiwei

AU - Chalmers, James D.

N1 - Bayer AG provided funding for performance of the systematic review and for editorial services. AF, FJ, AU and KW are employees of Bayer and as authors were involved in developing the concept, critically reviewing the systematic literature review and added additional insight as listed in the Authors’ contributions section below.

PY - 2019/2/28

Y1 - 2019/2/28

N2 - Background: The increasing prevalence and recognition of bronchiectasis in clinical practice necessitates a better understanding of the economic disease burden to improve the management and achieve better clinical and economic outcomes. This study aimed to assess the economic burden of bronchiectasis based on a review of published literature.Methods: A systematic literature review was conducted using MEDLINE, Embase, EconLit and Cochrane databases to identify publications (1 January 2001 to 31 December 2016) on the economic burden of bronchiectasis in adults.Results: A total of 26 publications were identified that reported resource use and costs associated with management of bronchiectasis. Two US studies reported annual incremental costs of bronchiectasis versus matched controls of US$5681 and US$2319 per patient. Twenty-four studies reported on hospitalization rates or duration of hospitalization for patients with bronchiectasis. Mean annual hospitalization rates per patient, reported in six studies, ranged from 0.3-1.3, while mean annual age-adjusted hospitalization rates, reported in four studies, ranged from 1.8-25.7 per 100,000 population. The average duration of hospitalization, reported in 12 studies, ranged from 2 to 17 days. Eight publications reported management costs of bronchiectasis. Total annual management costs of €3515 and €4672 per patient were reported in two Spanish studies. Two US studies reported total costs of approximately US$26,000 in patients without exacerbations, increasing to US$36,00-37,000 in patients with exacerbations. Similarly, a Spanish study reported higher total annual costs for patients with > 2 exacerbations per year (€7520) compared with those without exacerbations (€3892). P. aeruginosa infection increased management costs by US$31,551 to US$56,499, as reported in two US studies, with hospitalization being the main cost driver.Conclusions: The current literature suggests that the economic burden of bronchiectasis in society is significant. Hospitalization costs are the major driver behind these costs, especially in patients with frequent exacerbations. However, the true economic burden of bronchiectasis is likely to be underestimated because most studies were retrospective, used ICD-9-CM coding to identify patients, and often ignored outpatient burden and cost. We present a conceptual framework to facilitate a more comprehensive assessment of the true burden of bronchiectasis for individuals, healthcare systems and society.

AB - Background: The increasing prevalence and recognition of bronchiectasis in clinical practice necessitates a better understanding of the economic disease burden to improve the management and achieve better clinical and economic outcomes. This study aimed to assess the economic burden of bronchiectasis based on a review of published literature.Methods: A systematic literature review was conducted using MEDLINE, Embase, EconLit and Cochrane databases to identify publications (1 January 2001 to 31 December 2016) on the economic burden of bronchiectasis in adults.Results: A total of 26 publications were identified that reported resource use and costs associated with management of bronchiectasis. Two US studies reported annual incremental costs of bronchiectasis versus matched controls of US$5681 and US$2319 per patient. Twenty-four studies reported on hospitalization rates or duration of hospitalization for patients with bronchiectasis. Mean annual hospitalization rates per patient, reported in six studies, ranged from 0.3-1.3, while mean annual age-adjusted hospitalization rates, reported in four studies, ranged from 1.8-25.7 per 100,000 population. The average duration of hospitalization, reported in 12 studies, ranged from 2 to 17 days. Eight publications reported management costs of bronchiectasis. Total annual management costs of €3515 and €4672 per patient were reported in two Spanish studies. Two US studies reported total costs of approximately US$26,000 in patients without exacerbations, increasing to US$36,00-37,000 in patients with exacerbations. Similarly, a Spanish study reported higher total annual costs for patients with > 2 exacerbations per year (€7520) compared with those without exacerbations (€3892). P. aeruginosa infection increased management costs by US$31,551 to US$56,499, as reported in two US studies, with hospitalization being the main cost driver.Conclusions: The current literature suggests that the economic burden of bronchiectasis in society is significant. Hospitalization costs are the major driver behind these costs, especially in patients with frequent exacerbations. However, the true economic burden of bronchiectasis is likely to be underestimated because most studies were retrospective, used ICD-9-CM coding to identify patients, and often ignored outpatient burden and cost. We present a conceptual framework to facilitate a more comprehensive assessment of the true burden of bronchiectasis for individuals, healthcare systems and society.

KW - Burden of illness

KW - Bronchiectasis

KW - Resource use

KW - Costs

KW - Hospitalization

KW - Economic burden

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DO - 10.1186/s12890-019-0818-6

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SP - 1

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JF - BMC Pulmonary Medicine

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Goeminne PC, Hernandez F, Diel R, Filonenko A, Hughes R, Juelich F et al. The economic burden of bronchiectasis - known and unknown: a systematic review. BMC Pulmonary Medicine. 2019 Feb 28;19(1):1-11. 54. https://doi.org/10.1186/s12890-019-0818-6