Idiopathic pulmonary fibrosis care in Australia costs $299 million per year, with incidence rising over the past two decades, health economists have estimated.

To come up with the figure, researchers, led by Menzies Institute for Medical Research at the University of Tasmania, extrapolated the annual costs of idiopathic pulmonary fibrosis (IPF) care – estimated at AU$31,655 per person – to the likely prevalence of IPF nationally.

Writing in the Australian Journal of General Practice [link here], they said the annual costs related to IPF care were approximately four-fold greater than the annual national per capita expenditure on health in Australia for 2021 (AU$7927).

In contrast, data showed the national per capita expenditure for osteoarthritis was 0.1-fold the national average; for asthma, 1.7-fold; for diabetes, 1.1-fold; for COPD, 1.3-fold; for lung cancer, 6.3-fold and for cardiovascular disease,1.1-fold.

Antifibrotic agents and hospitalisations accounted for 74% of IPF-related costs.

Using data from the Australasian ILD Registry (AILDR), the researchers also showed a rising trend of IPF incidence and prevalence, with crude incidence increasing from 7.5 to 14.2 per 100,000 between 1997 and 2018.

Projections suggested a further rise to 16.3 per 100,000 by 2025.

Similarly, crude prevalence rose from 23.7 to 42.7 per 100,000 over the same two-decade period, and was projected to increase to 48.3 per 100,000 by 2025.

Mortality had also increased over the past decades, but had shown a slight decreasing trend recently, since the introduction of antifibrotic medication.

From 1997 until 2016, mortality increased from 5.2 to 6.8 per 100,000, declining to 6.6 per 100,000 in 2022, with projected estimates in 2025 of 6.4 per 100,000.

All estimates were higher in males than in females, and the highest rates of disease were observed in patients aged 70 and older, who accounted for approximately 82–83% of all IPF deaths, incident and prevalent cases, noted the researchers.

Health-related quality of life (HRQoL) was also poor in patients with IPF.

Data showed on average a 1–5% decline in HRQoL of a patient with each 10-point decrease in the spirometric FVC percent predicted, mainly influenced by attributes measuring physical health rather than psychosocial health, the researchers said.

Multimorbidity was associated with an even worse decline. For example, having two or more comorbidities led to worsened HRQoL by a further 16–26%.

Musculoskeletal comorbidities such as arthritis, osteoporosis and heart disease were the biggest contributors to a decrease in HRQoL, the researchers said.

“In general, people living with IPF had worse HRQoL than people living with angina, bronchiectasis, chronic kidney failure and even most individuals living with non-small cell lung cancer on treatment with no side effects, but similar to an individual living with a compensated stroke or chronic obstructive pulmonary disease (COPD),” they said.

“Early diagnosis and early treatment are pivotal to improving patient outcomes, HRQoL, reduced number of acute exacerbations and resultant cost savings.”

Some of the authors have previously received funding from pharmaceutical companies that manufacture IPF medication.