Direct Costs of Health Care of Cystic Fibrosis, The Case of A Health Insurer In Colombia

Cystic fibrosis (CF) is an autosomal recessive disease, caused by a gene mutation, with the inability to transport chloride in epithelial cells, mainly affecting lungs, pancreas and intestine. It is a chronic orphan disease, progressive and high cost that affects more frequently Caucasian population, with a prevalence of 1/2,000 to 1/2,500 in the world. OBJECTIVES: To estimate the direct costs associated with the care of CF patients affiliated to a health insurer in Colombia during the period 2010-2015. METHODS: A retrospective study was conducted of a dynamic cohort of 40 patients distributed in 10 cities of the national territory and affiliated to a health insurer in Colombia, duringjanuary 2010 to December 2015.The demographic characteristics of the cohort are described and the average annual costs per health service and per patient were estimated. The costs were adjusted by inflation and expressed in American dollars for the year 2017. RESULTS: The prevalence of CF was 1.96 per 100,000 persons, 60% were men, the mean age was 9.8 years (SD 5.7 years), the cities with the highest concentration of patients were Bogota (27.5%), Ibague (20%) and Medellin (15%). The average cost of annual attendance of patients in the cohort was $434,674, distributed in: drugs (68.7%), followed by hospitalization with (6.5%), critical care (4.6%), household medicine (3.6%), diagnostic and therapeutic procedures (2.9%) and clinical laboratory (2.0%). The average cost per patient annual was $9,555 (2010), $9,506 (2011), $8,666 (2012), $12,108 (2013), $12,609 (2014) and $12,757 (2015). CONCLUSIONS: The average annual cost per patient of CF in the cohort evaluated is equivalent to the annual per capita premium of 50.2 patients by 2015.There is evidence of an increase in the cost per patient between 2012 and 2013 that could correspond to the introduction of new technologies in the Colombian market.