first insights into the cost of treatment of interstitial lung diseases in germany – analysis of the exciting ild register

Background There is lack of evidence on the healthcare situation of those affected by interstitial lung diseases, especially in Germany. This has been exacerbated by the introduction of the new classification for interstitial lung diseases. The focus has been on idiopathic pulmonary fibrosis and sarcoidosis and the entities with low severity are neglected. We use the data to examine the extent of medical services of people with different ILD subtypes and the resulting costs.

Methods We calculated costs estimated for hospital stays in days and consultation costs due to ILD. Additionally, we assessed the costs of therapy (drug therapy, physiotherapy, medical aids and rehabilitation). 299 patients from the register who underwent treatment within one year after diagnosis were eligible for the analysis. We used a generalized linear gamma regression to test for differences between ILD subtypes and other patient characteristics.

Results ILD subtypes were grouped as follows; IPF (n = 74, 25%), other IIPs (NSIP, DIP, COP) (n = 54, 18%), Sarcoidosis (n = 65, 22%), EAA (n = 40, 13%), Rheumatic and Connective Tissue Disease (n = 24, 8%) and other (n = 42, 14%). The mean costs of treatment within one year after diagnosis were 3354.15 €. We found significant differences in costs of care between different ILD-subtypes (p = 0.01). We also adjusted for sex (p = 0.20), age (p = 0.14), smoking and number of pack years (p = 0.83). These other covariates had no significant effect on the mean costs.

Conclusion Our results show that treatment costs differ across ILD subtypes. However, it cannot be excluded that different care pathways (e.g. hospital-based vs. outpatient-based) result in similar overall spending. Thus, a more detailed look at the distinct components of costs of care is urgently needed to comprehensively address economic burden in various ILDs.