A 10-year cost trajectory study in children with cystic fibrosis in France

<bold>Background:</bold> Few is known about the medical costs associated with the early management of cystic fibrosis (CF). We aimed to report the medical costs associated with CF in children diagnosed either antenatally (ANT), by newborn screening (NBS), after meconium ileus (MI), or latter based on symptoms (LS). <bold>Methods and results:</bold> Data from the French CF Registry (FCFR) and the French national claims database (SNDS) were linked from 2006-2021. The costs of CF by circumstances of diagnosis were estimated per year of life in children with CF (chCF) up to 10 y. Group-based trajectory modeling was performed to identify subgroups with similar cost trajectories. 779 chCF were born between 2006 and 2019 and had at least 10 years' of follow-up. IM (N=101, 13.0%) and ANT (N=39, 5.0%) chCF had higher costs at baseline (€20,752 and €19,659, respectively) than NBS (N=601, 77.2%, €12,056) or LS (N=38, 4.9%, €13,861). Overall, costs decreased during the 2nd year of life and increased to around €20k in the 10th year. Three groups with different cost trajectories were identified. A “low cost” group with a mean cost of €11,015 in the 1st year of life that rose from the 4th year to reach €12,948 in the 10th year. A “Medium” and “high cost” groups with a mean cost of €20k in the 1st year, which rose to €32,987 and €64,233 in the 10th year. Differences between the groups were found for FEV1, height and weight, treatments and comorbidities (all p<0.05). <bold>Conclusion:</bold> These results showed that the costs were lower in patients diagnosed with NBS and might follow 3 cost trajectories starting early in life which supports the need for early use of CFTRm in chCF. <bold>Acknowledgement:</bold> This work was supported by a grant from Vaincre la Mucoviscidose.