Elexacaftor/Tezacaftor/Ivacaftor for Cystic Fibrosis: Impact on Hospitalizations and Health Care Resource Utilization in a Universal Health Care Setting
Abstract Introduction Elexacaftor/tezacaftor/ivacaftor (ETI) has been shown to substantially improve clinical outcomes among people living with cystic fibrosis (pwCF). The impact of ETI on health care resource utilization in the context of universal health care is largely unknown. We aimed to assess...
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Adis, Springer Healthcare
2025-02-01
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| Series: | Pulmonary Therapy |
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| Online Access: | https://doi.org/10.1007/s41030-025-00287-1 |
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| author | Hans Kristian Råket Mikkel Zöllner Ankarfeldt Joanna Nan Wang Tacjana Pressler Søren Jensen-Fangel Tavs Qvist Daniel Faurholt-Jepsen Espen Jimenez-Solem Janne Petersen Camilla Bjørn Jensen on behalf of the TransformCF Study Group |
| author_facet | Hans Kristian Råket Mikkel Zöllner Ankarfeldt Joanna Nan Wang Tacjana Pressler Søren Jensen-Fangel Tavs Qvist Daniel Faurholt-Jepsen Espen Jimenez-Solem Janne Petersen Camilla Bjørn Jensen on behalf of the TransformCF Study Group |
| author_sort | Hans Kristian Råket |
| collection | DOAJ |
| description | Abstract Introduction Elexacaftor/tezacaftor/ivacaftor (ETI) has been shown to substantially improve clinical outcomes among people living with cystic fibrosis (pwCF). The impact of ETI on health care resource utilization in the context of universal health care is largely unknown. We aimed to assess the impact of ETI on hospital and non-hospital health care resource utilization in a national cohort of pwCF up to 2 years after ETI initiation. Methods We included all pwCF aged 12 years or older in the Danish Cystic Fibrosis Cohort initiating ETI therapy between 1 September 2020 and 31 December 2022. The following health care contacts were reported: acute and elective hospitalizations, acute and elective outpatient contacts, general practitioner (GP) visits, other specialist visits, physiotherapist/chiropractor visits, pharmacy visits, and blood sampling appointments. Pre- and post-ETI data were analyzed using logistic and linear regression models estimating number of visits, days in hospital, and odds ratios (ORs) for one monthly contact. Results A total of 283 pwCF initiated ETI in the study period. At 24 months post-ETI, utilization of the following health care resources was reduced: elective hospitalizations [OR 0.20 (95% CI: 0.08; 0.50)], elective outpatient hospital contacts [0.70 (0.57; 0.86)], pharmacy visits [0.56 (0.45; 0.71)], and blood sampling appointments [0.61 (0.49; 0.77)]. Number of contacts per month was reduced for the aforementioned outcomes, as well as number of days in hospital for elective hospitalizations. A downward but not statistically significant trend was observed for acute hospitalizations. No significant change was observed for acute outpatient visits, GP visits, other specialist visits, or visits to a physiotherapist/chiropractor. Conclusion In a national cohort of pwCF, ETI was associated with substantial reductions in elective hospitalizations, elective outpatient contacts, duration of elective hospitalizations, pharmacy visits, and blood sampling appointments, sustained 2 years post-ETI initiation. These findings highlight the real-world effectiveness of ETI in the context of a universal health care system. |
| format | Article |
| id | doaj-art-e466abafe0ea44158cc2553a89e2993a |
| institution | OA Journals |
| issn | 2364-1754 2364-1746 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Pulmonary Therapy |
| spelling | doaj-art-e466abafe0ea44158cc2553a89e2993a2025-08-20T02:29:51ZengAdis, Springer HealthcarePulmonary Therapy2364-17542364-17462025-02-0111223524710.1007/s41030-025-00287-1Elexacaftor/Tezacaftor/Ivacaftor for Cystic Fibrosis: Impact on Hospitalizations and Health Care Resource Utilization in a Universal Health Care SettingHans Kristian Råket0Mikkel Zöllner Ankarfeldt1Joanna Nan Wang2Tacjana Pressler3Søren Jensen-Fangel4Tavs Qvist5Daniel Faurholt-Jepsen6Espen Jimenez-Solem7Janne Petersen8Camilla Bjørn Jensen9on behalf of the TransformCF Study GroupDepartment of Clinical Pharmacology, Bispebjerg and Frederiksberg, Bispebjerg Hospital, Copenhagen University HospitalCopenhagen Phase IV Unit, Department of Clinical Pharmacology and Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg, Copenhagen University HospitalDepartment of Clinical Pharmacology, Bispebjerg and Frederiksberg, Bispebjerg Hospital, Copenhagen University HospitalDepartment of Infectious Diseases, Cystic Fibrosis Centre, Copenhagen University Hospital–RigshospitaletDepartment of Infectious Diseases, Aarhus University HospitalDepartment of Infectious Diseases, Cystic Fibrosis Centre, Copenhagen University Hospital–RigshospitaletDepartment of Infectious Diseases, Cystic Fibrosis Centre, Copenhagen University Hospital–RigshospitaletDepartment of Clinical Pharmacology, Bispebjerg and Frederiksberg, Bispebjerg Hospital, Copenhagen University HospitalCopenhagen Phase IV Unit, Department of Clinical Pharmacology and Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg, Copenhagen University HospitalCopenhagen Phase IV Unit, Department of Clinical Pharmacology and Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg, Copenhagen University HospitalAbstract Introduction Elexacaftor/tezacaftor/ivacaftor (ETI) has been shown to substantially improve clinical outcomes among people living with cystic fibrosis (pwCF). The impact of ETI on health care resource utilization in the context of universal health care is largely unknown. We aimed to assess the impact of ETI on hospital and non-hospital health care resource utilization in a national cohort of pwCF up to 2 years after ETI initiation. Methods We included all pwCF aged 12 years or older in the Danish Cystic Fibrosis Cohort initiating ETI therapy between 1 September 2020 and 31 December 2022. The following health care contacts were reported: acute and elective hospitalizations, acute and elective outpatient contacts, general practitioner (GP) visits, other specialist visits, physiotherapist/chiropractor visits, pharmacy visits, and blood sampling appointments. Pre- and post-ETI data were analyzed using logistic and linear regression models estimating number of visits, days in hospital, and odds ratios (ORs) for one monthly contact. Results A total of 283 pwCF initiated ETI in the study period. At 24 months post-ETI, utilization of the following health care resources was reduced: elective hospitalizations [OR 0.20 (95% CI: 0.08; 0.50)], elective outpatient hospital contacts [0.70 (0.57; 0.86)], pharmacy visits [0.56 (0.45; 0.71)], and blood sampling appointments [0.61 (0.49; 0.77)]. Number of contacts per month was reduced for the aforementioned outcomes, as well as number of days in hospital for elective hospitalizations. A downward but not statistically significant trend was observed for acute hospitalizations. No significant change was observed for acute outpatient visits, GP visits, other specialist visits, or visits to a physiotherapist/chiropractor. Conclusion In a national cohort of pwCF, ETI was associated with substantial reductions in elective hospitalizations, elective outpatient contacts, duration of elective hospitalizations, pharmacy visits, and blood sampling appointments, sustained 2 years post-ETI initiation. These findings highlight the real-world effectiveness of ETI in the context of a universal health care system.https://doi.org/10.1007/s41030-025-00287-1Cystic fibrosisHealth care resource utilizationHospitalizationUniversal health careElexacaftor/tezacaftor/ivacaftor |
| spellingShingle | Hans Kristian Råket Mikkel Zöllner Ankarfeldt Joanna Nan Wang Tacjana Pressler Søren Jensen-Fangel Tavs Qvist Daniel Faurholt-Jepsen Espen Jimenez-Solem Janne Petersen Camilla Bjørn Jensen on behalf of the TransformCF Study Group Elexacaftor/Tezacaftor/Ivacaftor for Cystic Fibrosis: Impact on Hospitalizations and Health Care Resource Utilization in a Universal Health Care Setting Pulmonary Therapy Cystic fibrosis Health care resource utilization Hospitalization Universal health care Elexacaftor/tezacaftor/ivacaftor |
| title | Elexacaftor/Tezacaftor/Ivacaftor for Cystic Fibrosis: Impact on Hospitalizations and Health Care Resource Utilization in a Universal Health Care Setting |
| title_full | Elexacaftor/Tezacaftor/Ivacaftor for Cystic Fibrosis: Impact on Hospitalizations and Health Care Resource Utilization in a Universal Health Care Setting |
| title_fullStr | Elexacaftor/Tezacaftor/Ivacaftor for Cystic Fibrosis: Impact on Hospitalizations and Health Care Resource Utilization in a Universal Health Care Setting |
| title_full_unstemmed | Elexacaftor/Tezacaftor/Ivacaftor for Cystic Fibrosis: Impact on Hospitalizations and Health Care Resource Utilization in a Universal Health Care Setting |
| title_short | Elexacaftor/Tezacaftor/Ivacaftor for Cystic Fibrosis: Impact on Hospitalizations and Health Care Resource Utilization in a Universal Health Care Setting |
| title_sort | elexacaftor tezacaftor ivacaftor for cystic fibrosis impact on hospitalizations and health care resource utilization in a universal health care setting |
| topic | Cystic fibrosis Health care resource utilization Hospitalization Universal health care Elexacaftor/tezacaftor/ivacaftor |
| url | https://doi.org/10.1007/s41030-025-00287-1 |
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