OBJECTIVES:

To explore and uncover the cost of managing Non‐Tuberculous Mycobacterial Lung Disease (NTMLD) in the United Kingdom

METHODS:

Face to face and telephone interviews were conducted with physicians in six UK centres covering England, Northern Ireland and Scotland to discuss management pathways for NTMLD. Thirteen patient cases were collected, out of which seven were actual cases and six were illustrated as typical cases by managing physicians. Both mild and severe cases were included and distinguished by species causing NTMLD – ten patients had NTMLD caused by Mycobacterium Avium Complex (MAC), two by Mycobacterium abscessus (Mab) and one by Mycobacterium malmoense. NHS costs were assessed utilising NHS Reference costing and HRG costing to fairly gauge the real cost of managing NTM. We quantified costs of inpatient stay, consultations, diagnostics, and pharmacotherapy, all related solely to NTMLD management.

RESULTS:

Costs of managing NTMLD (HRG costing) ranged from £2,628.64 for 12 months of treatment without resolving disease (MAC patient) to £44,540.82 for 18 months of ongoing treatment (Mab patient). Highest cost related to MAC was £19,099.08 for 18 months months of treatment without resolving disease. On average hospital, pharmacotherapy and diagnostic costs contribute 27%, 57% and 17% of the total cost of treatment, respectively. However for more severe cases, the hospital costs related to inpatient stay contributed to 74% of total costs.

CONCLUSIONS:

There is high variability in costs of managing NTM, depending on disease severity and possibly also on species causing the disease. In more severe patients, inpatient stay is the main cost driver. Thus, there may be a strong argument that delay in escalation of treatment could lead to increase in potentially unnecessary resource utilisation costs and burden upon the healthcare system.