TY - JOUR T1 - Economic burden of bronchiectasis in Germany JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02033-2018 SP - 1802033 AU - Roland Diel AU - James D. Chalmers AU - Klaus F. Rabe AU - Albert Nienhaus AU - Robert Loddenkemper AU - Felix C. Ringshausen Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/11/28/13993003.02033-2018.abstract N2 - Estimates of healthcare costs for incident bronchiectasis patients are currently not available for any European country. Out of a sample of 4 859 013 persons covered by German statutory health insurance companies, 231 new bronchiectasis patients were identified in 2012. They were matched with 685 control patients by age, gender and Charlson Comorbidity Index and followed for 3 years.The total direct expenditure during that period per insured bronchiectasis patient was €18,634.57 [95%CI: €15,891.02–€23,871.12], nearly one third higher (ratio of mean 1.31 [95%CI: 1.02–1.68]) than for a matched control (p<0.001).Hospitalisation costs contributed to 35% of the total and were more than 50% higher in the bronchiectasis group (1.56 [95%CI: 1.20–3.01]; p<0.001); on average, bronchiectasis patients spent 4.9 more days [95%CI: 2.27–7.43] in hospital (p<0.001). Antibiotics expenditures per bronchiectasis outpatient (€413.81) were nearly five times higher than those for a matched control (4.85 [95%CI 2.72–8.64]).Each bronchiectasis patient had on average 40.5 [95%CI: 17.1–43.5] sick leave days and induced work-loss costs of €4,230.49 [95%CI: €2,849.58–€5,611.20].The mortality rate for bronchiectasis and matched non-bronchiectasis patients after 3 years of follow up was 26.4% and 10.5%, respectively (p<0.001). Mortality in the bronchiectasis group was higher among those who also had COPD than in patients with bronchiectasis alone (35.9% and 14.6%, respectively; p<0.001).Although bronchiectasis is considered underdiagnosed, the mortality and associated financial burden in Germany are substantial.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Nienhaus has nothing to disclose.Conflict of interest: Dr. Chalmers reports other from European Respiratory Journal, during the conduct of the study; grants and personal fees from Glaxosmithkline, grants and personal fees from Boehringer-Ingelheim, grants from Astrazeneca, grants and personal fees from Pfizer, grants and personal fees from Bayer Healthcare, grants and personal fees from Grifols, personal fees from Napp, personal fees from Aradigm corporation, grants and personal fees from Insmed, outside the submitted work.Conflict of interest: Dr. Diel reports grants from Bayer Vital, during the conduct of the study; personal fees from Insmed Incorporation, personal fees from Bayer Vital, outside the submitted work.Conflict of interest: Dr. Loddenkemper has nothing to disclose.Conflict of interest: Dr. Rabe has nothing to disclose.Conflict of interest: Dr. Ringshausen reports grants, personal fees and other from Bayer HealthCare, grants and personal fees from Grifols Germany, grants, personal fees and other from Insmed Germany, personal fees from Astra Zeneca, personal fees and other from Chiesi, other from Abbott, personal fees and other from Gilead, other from Pfizer, other from Oxycare, grants, personal fees and other from Novartis, other from Heinen & Löwenstein, other from MSD, grants and other from InfectoPharm, other from Vertex, other from Parion, other from Celtaxsys, other from Corbus, other from GSK, grants from Polyphor, personal fees from Boehringer Ingelheim, other from PARI, other from APOSAN, other from Zambon, other from Heinen+Löwenstein, outside the submitted work. ER -