Future of Care for Patients With Interstitial Lung Disease

In the third installment of this video series, Dr Ross Summer offers insight to payers on the care needed for interstitial lung disease and shares where he believes the future of care for this patient population is heading.

This interview is a part of the video series “Inside Interstitial Lung Disease: Overall Burden, Therapy Options, & Looking Ahead.”

Read the full transcript:

My name is Ross Summer, and I am a physician-scientist here at Thomas Jefferson University. I'm also the section chief of pulmonary and critical care and the director of the Interstitial Lung Disease Program at Thomas Jefferson University Hospital in Philadelphia.

What is something you would want payers and other stakeholders to better understand about the management of fibrosing interstitial lung diseases?

In my mind, there are 2 things that I would like payers and other stakeholders to know about these conditions. Number one, the diagnosis is very difficult to make, and there is an upfront cost to getting the diagnosis right. This may require seeing rheumatologists, doing specialized tests, CT scans, possibly bronchoscopies, even lung biopsies. There ae going to be a lot of blood tests that are required in order to get the diagnosis right. This is very important because the longer the delay is, I think, the more wasted money there is in the health care system and unnecessary doctors and stress to the patients. Knowing that there's an upfront cost and accepting that, I think, will ultimately be cost reducing in the future.

The second important point is that these conditions require close monitoring. Because we don't know the natural history of many of these conditions in the sense that for each individual, we know it on a population base, but for patient number one, we don't know exactly what their course would be, and these conditions can be very unpredictable.

By closely monitoring them, we can intervene early, possibly through clinical trials, or transplant, or adding other interventions. And so, if we're not able to follow these patients closely, we're going to miss a lot of patients, and I think outcomes are going to be worse. So those are my two big points.

Where do you see the future of ILD care heading?

I see a very bright future for ILD. This field has already moved very far in my career, and I expect it to move even further. I think treatments are going to be radically different, that they're going to be targeted to specific types, but there's going to be a multi-prong approach to treating these conditions.

In addition to the antifibrotic agents, we may have treatments that reduce inflammation but also help to restore the epithelium, the lining of the lung, to bring health and regeneration to the lung.

I also think that screening, maybe, in the future, just like we screen for heart disease and we screen for cancer. There are no screening tests for interstitial lung disease, and I think that leads to delays in diagnosis, and I'm hopeful that there'll be testing for screening in the not-too-distant future.

The third aspect that I see in the future is prevention. We know a lot about what causes cancers, and we do things to avoid that, for example, smoking cessation. We know many things that prevent heart disease, like proper diets and medications to help reduce cholesterol, but there's nothing we really tell our patients at a young age to protect the lung. And I think most forms of pulmonary fibrosis are from environmental exposures, and so a lifetime of environmental exposures. And people need to know that what we breathe into our lungs, cigarette smoke, environmental exposures, and dusts, and things like that can have long-term consequences. I think the focus on prevention will be important in the future too.

This transcript has been edited for clarity.