Researchers reported that nintedanib was associated with higher costs for medications, medical visits, as well as a higher global cost compared with pirfenidone—both drugs used to treat idiopathic pulmonary fibrosis (IPF).

These results were published in Respiratory Medicine and Research.

IPF is a progressive and ultimately lethal lung disease of unknown cause. The prognosis remains extremely poor: a mere 2 to 5 years from diagnosis, even with treatment with antifibrotic medications such as nintedanib and pirfenidone. Both of these drugs became available in France between 2012 and 2015. 

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Both these medications have been clinically proven to slow decline in forced vital capacity and improve progression-free survival. Combined with other studies from Australia and wider Europe, the data clearly indicate that patients with IPF who are on these medications have better survival. Nevertheless, direct comparisons between the 2 medications remain scarce. In this study, the research team sought to investigate a particular aspect pertinent to both medications: their healthcare resource utilization and associated costs. 

Read more about IPF etiology 

The team accessed digital data from a national database that covers over 98% of the population living in France, which includes over 65 million inhabitants. The database includes detailed information on healthcare resource utilization and is one of the largest in the world. 

This retrospective study included patients with IPF who were newly treated with nintedanib or pirfenidone between January 1, 2015 and December 31, 2016. Only patients who were continuously covered by the French National Health Service were included in this trial. Only patients 50 years and older were included in the study. 

The results demonstrated that after adjustment for confounding factors, nintedanib was associated with higher medication costs, medical visits, and a higher overall cost compared with pirfenidone. There were no significant differences between the 2 drugs in terms of medical procedures, hospitalizations, and indirect costs. 

“These real-world data suggest potential differences in [healthcare resource utilization]-related costs between IPF medications that warrant further exploration with different datasets and approaches,” the authors of the study concluded. 


Cottin V, Spagnolo P, Bonniaud P, et al. Healthcare resource use and associated costs in patients receiving pirfenidone or nintedanib for idiopathic pulmonary fibrosisRespir Med Res. 2022;83:100951. doi:10.1016/j.resmer.2022.100951