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To highlight economic burden of drug treatment in different ILD-subtypes we assessed cost trends and therewith-associated drivers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from the German, observational HILDA study we estimated adjusted mean medication costs over 36-month intervals using one- and two-part Generalized Estimating Equation (GEE) regression models with a gamma distribution and log link. Next, we determined factors associated with costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In Idiopathic pulmonary fibrosis (IPF) mean per capita medication costs increased from \u20ac1442 before to \u20ac11,000\u20ac at the end of study. In non-IPF subtypes, the increase took place at much lower level. Mean per capita ILD-specific medication costs at the end of the study ranged between \u20ac487 (other ILD) and \u20ac9142 (IPF). At baseline, higher FVC %predicted values were associated with lower medication costs in IPF (\u22129%) and sarcoidosis (\u22121%). During follow up higher comorbidity burden escalated costs in progressive fibrosing ILD (PF-ILD) (+52%), sarcoidosis (+60%) and other ILDs (+24%). The effect of disease duration was not uniform, with cost savings in PF-ILD (\u22128%) and sarcoidosis (\u22126%), but increased spending in IPF (+11%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pharmacological management of ILD, in particular of IPF imposes a substantial economic burden on the healthcare system. Strategies to reduce comorbidity burden and early treatment may reduce the impact of ILDs on the healthcare system.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12931-021-01807-8","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T16:21:40Z","timestamp":1628007700000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cost drivers in the pharmacological treatment of interstitial lung disease"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3301-3874","authenticated-orcid":false,"given":"Phillen Nozibuyiso","family":"Maqhuzu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Kreuter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Bahmer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Kahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Claussen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Holle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa","family":"Schwarzkopf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"1807_CR1","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1186\/s12916-015-0487-0","volume":"13","author":"S Disayabutr","year":"2015","unstructured":"Disayabutr S, Calfee CS, Collard HR, Wolters PJ. 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