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07.01.2016 | Original Paper | Ausgabe 1/2017

The European Journal of Health Economics 1/2017

Cost-of-illness analysis and regression modeling in cystic fibrosis: a retrospective prevalence-based study

The European Journal of Health Economics > Ausgabe 1/2017
Tomáš Mlčoch, Jiří Klimeš, Libor Fila, Věra Vávrová, Veronika Skalická, Marek Turnovec, Veronika Krulišová, Jitka Jirčíková, Dana Zemková, Klára Vilimovská Dědečková, Alena Bílková, Vladimíra Frühaufová, Lukáš Homola, Zuzana Friedmannová, Radovan Drnek, Pavel Dřevínek, Tomáš Doležal, Milan Macek Jr.
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s10198-015-0759-9) contains supplementary material, which is available to authorized users.



Economic data pertaining to cystic fibrosis (CF), is limited in Europe generally, and completely lacking in Central and Eastern Europe. We performed an analysis of all direct costs associated with CF relative to key disease features and laboratory examinations.


A retrospective prevalence-based cost-of-illness (COI) study was performed in a representative cohort of 242 CF patients in the Czech Republic, which represents about 65 % of all Czech CF patients. Medical records and invoices to health insurance companies for reference year 2010 were analyzed.


The mean total health care costs were €14,486 per patient, with the majority of the costs going towards medicinal products and devices (€10,321). Medical procedures (€2676) and inpatient care (€1829) represented a much smaller percentage of costs. A generalized linear model showed that the strongest cost drivers, for all cost categories, were associated with patient age and lung disease severity (assessed using the FEV1 spirometric parameter), when compounded by chronic Pseudomonas aeruginosa airway infections. Specifically, maximum total costs are around the age 16 years; a FEV1 increase of 1 % point represented a cost decrease of: 0.9 % (medicinal products), 1.7 % (total costs), 2.8 % (procedures) and 7.0 % (inpatient care).


COI analysis and regression modeling using the most recent data available can provide a better understanding of the overall economic CF burden. A comparison of our results with other methodologically similar studies demonstrates that although overall costs may differ, FEV1 can nonetheless be utilized as a generally transferrable indicator of the relative economic impact of CF.

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Supplementary material 1 (DOCX 55 kb)
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