Cost-effectiveness of earlier diagnosis of interstitial lung diseases (ILDs) and treatment of its progressive form, progressive pulmonary fibrosis (PPF)

<bold>Introduction:</bold> Early treatment for progressive pulmonary fibrosis (PPF) improves outcomes. However, diagnosis of interstitial lung diseases (ILDs), and detection of PPF is delayed on average by 9-12 months. New ILD diagnostic and PPF monitoring strategies are being investigated that aim to permit early treatment to improve patient outcomes. <bold>Objective:</bold> The study investigated health economic outcomes of early diagnosis of ILD and detection of PPF in six European countries. <bold>Methods:</bold> A time-to-event cost effectiveness model of reducing delays in ILD diagnosis and detection of PPF was developed. Model inputs were obtained from ILD expert clinicians, literature, and statistical progression equations based on the INBUILD trial. Discounted health economic outcomes were calculated for six European countries. <bold>Results:</bold> Outcomes are reported for 6 months reduction in the delay time to ILD diagnosis and 7.9 months for PPF detection. Clinical benefits arise from any delay reduction, and are driven by postponing the development of PPF and more timely treatment of PPF with nintedanib. <table-wrap><object-id>erj;64/suppl_68/PA696/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td><bold>Belgium</bold></td><td><bold>Netherlands</bold></td><td><bold>Denmark</bold></td><td><bold>Finland</bold></td><td><bold>Norway</bold></td><td><bold>Sweden</bold></td><td><bold>Median</bold></td></tr><tr><td>Life Year gain</td><td> 0.11 0.38 </td><td> 0.12 0.41 </td><td> 0.12 0.40 </td><td> 0.10 0.35 </td><td> 0.10 0.34 </td><td> 0.10 0.36 </td><td> <bold>0.11</bold> <bold>0.37</bold> </td></tr><tr><td>Quality-Adjusted Life Year gain</td><td> 0.08 0.28 </td><td> 0.09 0.30 </td><td> 0.09 0.30 </td><td> 0.08 0.27 </td><td> 0.07 0.25 </td><td> 0.08 0.27 </td><td> <bold>0.08</bold> <bold>0.28</bold> </td></tr><tr><td> Incremental Cost-Effectiveness Ratio </td><td> €20643 €16721 </td><td> €27162 €24823 </td><td> €31612 €26590 </td><td> €32776 €24418 </td><td> €39798 €34166 </td><td> €30144 €24692 </td><td> <bold>€30878</bold> <bold>€24758</bold> </td></tr></tbody></table></table-wrap> <italic><bold>Top</bold>=All ILD</italic> <italic><bold>Bottom</bold>=PPF-developing ILD</italic> <bold>Conclusion:</bold> Early diagnosis of ILD and detection of PPF yields cost-effective clinical benefits, supporting adoption of approaches to speed up ILD diagnosis and PPF detection.