The cost-effectiveness of counselling and consenting patients to start nintedanib for progressive pulmonary fibrosis (PPF) in a group setting: early experiences from a UK tertiary centre

<bold>Background:</bold> Access to antifibrotic medication in the UK for idiopathic pulmonary fibrosis (IPF) and PPF is only available from a tertiary specialist centre, following a multi-disciplinary team discussion. Starting treatment safely requires an in-depth talk about risks vs benefits of treatment, a medical screener and the patient’s consent. Our centre piloted a group counselling clinic in 2022, to prevent a backlog of patients waiting to start nintedanib when the prescribing regulations were updated to include PPF as an indication for treatment. Method: The clinic was evaluated to assess its benefits and cost-effectiveness. It was compared to telephone clinics used for antifibrotic counselling. An action plan was formed to improve this service in the future. <bold>Results:</bold> 146 patients attended 21 group sessions between April 2022 and December 2023. The clinic capacity is 8. The mean average number of patients in a group session was 6.95, the median was 7. Counselling 7 people individually by phone would take 5.25 hours of clinic time, whilst group sessions take 4 hours of clinic time, saving 1.25 hours per session. Other benefits of group counselling session include same day bloods, ECGs and blood pressure checks, access to handouts and leaflets, the chance for patients and carers to see and speak to others in a similar situation and meeting multiple members of the ILD team. <bold>Conclusion:</bold> Group medication counselling clinics are time saving for healthcare providers and patients. Improvements to the clinic include increasing the clinic capacity and adjusting nurse and admin time to help accommodate this.