Patients with non-tuberculosis mycobacterium pulmonary disease (NTM-PD) had four times higher mortality and a greater financial burden over a 39-month period than other patients, according to the results of a new study in Germany. People with a predisposition for chronic pulmonary disease, such as bronchiectasis or chronic obstructive pulmonary disease (COPD), are particularly susceptible to NTM-PD.

The study, “Burden Of Non-Tuberculous Mycobacterial Pulmonary Disease In Germany,” was published in the European Respiratory Journal.

NTM-PD is a rare disease, but in recent years, its incidence, prevalence, hospitalization rate, and mortality have been on the rise. The condition arises from an infection by mycobacteria that live in soil and water.

The study included 125 newly diagnosed NTM-PD patients matched with 1,250 control patients by age, gender, and Charlson Comorbidity Index (a measure of the one-year mortality risk and burden of disease).

Researchers found that, over a period of 39 months (more than three years):

• The incidence rate for NTM-PD was 2.6 per 100,000 insured people;
• The mortality rate in the NTM-PD group was about 22%, compared to 6% in the control group;
• The financial burden per NTM-PD patient was €39,559.60 euros (about $43,421 U.S.), which corresponded to about four times more than what a patient in the control group spent (€10,006.71 euros, or about $10,983 U.S.);
• Hospitalizations were three times higher in the NTM-PD group, accounting for 63% of the total costs;
• Attributable annual direct costs and indirect work-loss costs in NTM-PD patients were €9,093.20 (nearly $9,981 U.S.), compared to €1,221.05 (or about $1,340) per control patient;
• Only 74% of the NTM-PD patients received antibiotic treatment, with 54% being prescribed this treatment upon diagnosis, whereas 26% of patients never received antibiotics;
• Among those treated with antibiotics, nearly 26% were prescribed with clarithromycin in combination with ethambutol, about 19% were given a triple combo treatment with clarithromycin/rifampicin/ethambutol, and 15% received treatment with rifabutin and ethambutol.

“Although NTM-PD is considered rare, these findings highlight that the burden of the disease is high,” Michael Loebinger, study’s author, said in a news release. “Treatment can be hard to tolerate and may be unsuccessful, making treatment decisions complex. To help with this challenge, the British Thoracic Society will be releasing new guidelines this year.”