Back to Journals » ClinicoEconomics and Outcomes Research » Volume 10

The burden of cystic fibrosis in the Medicaid population

Authors Hassan M, Bonafede MM, Limone BL, Hodgkins P, Sawicki GS

Received 9 January 2018

Accepted for publication 26 April 2018

Published 25 July 2018 Volume 2018:10 Pages 423—431


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Dean Smith

Mariam Hassan,1 Machaon M Bonafede,2 Brendan L Limone,2 Paul Hodgkins,1 Gregory S Sawicki3

1Global Health Economics and Outcomes Research, Vertex Pharmaceuticals Incorporated, Boston, MA, USA; 2Life Sciences, Truven Health Analytics, Cambridge, MA, USA; 3Division of Respiratory Diseases, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

Purpose: To conduct an analysis describing clinical characteristics, pulmonary exacerbation (PEx) events, and health care resource utilization among Medicaid-insured patients with cystic fibrosis (CF).
Patients and methods: A retrospective analysis of the Truven Health MarketScan® Medicaid Multi-State administrative claims database (2010–2014) was undertaken. Patients aged ≥6 years with a CF diagnosis, continuously enrolled for 12 months, were identified. Demographics, comorbidities, PEx events, and health care resource utilization and costs over a 12-month enrollment period were analyzed for all patients and by age groups.
Results: In total, 1196 patients with CF aged ≥6 years were identified from a sample size of approximately 10 million Medicaid patients. Mean (SD) age was 16.1 (8.8) years. A greater proportion of patients were in younger age groups (6–11 years: 35.5%, 12–17 years: 29.1%, 18–26 years: 25.6%, 27–34 years: 6.7%, ≥35 years: 3.2%). Across all age groups, approximately 90% of patients had at least 1 PEx event; 50.7% of those had a PEx event involving treatment with intravenous antibiotics, and 42.8% required hospitalization. PEx recurrence was frequent: 55.7% of all patients experienced ≥3 PEx events during 1 year. Mean (SD) health care expenditures during a PEx event rose with increasing age, ranging from US$44,589 (US$139,024) to US$116,169 (US$387,752). Overall health care resource utilization was high among patients with CF; 47.2% of the population required an inpatient admission, and 26.8% had subsequent hospitalizations totaling 29.1 days per year in hospital.
Conclusion: High rates of PEx, hospitalizations, and time spent in hospital demonstrate the significant health care burden of CF among Medicaid beneficiaries.

Keywords: resource utilization, length of stay, pulmonary exacerbations

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]