Abstract
BackgroundGroup 3 pulmonary hypertension (PH) encompasses PH owing to lung diseases and/or hypoxia. Treatment patterns, healthcare resource use, and economic burden to US payers of Group 3 PH patients were assessed.MethodsThis retrospective observational study extracted data from July 1, 2010 to June 30, 2013 from two Truven Health Analytics MarketScan databases. Adult Group 3 PH patients were identified based on claims for PH (ICD-9-CM 416.0/416.8), a related lung disease, and an echocardiogram or right heart catheterization (RHC). The index date was the date of the first PH claim; data were collected for 12 months pre- and post-index. A difference-in-difference approach using generalized estimating equations was done to account for baseline differences.ResultsGroup 3 PH patients (n = 2,236) were matched 1:1 to controls on lung disease. PH patients had higher all-cause resource utilization and annual healthcare costs ($44,732 vs. $7,051) than controls. Costs were driven by inpatient admissions (35.4% of total costs), prescriptions (33.0%), and outpatient care (26.5%). Respiratory-related costs accounted for 11.4% of post-index annual costs for PH patients. PH diagnosis was not confirmed in the majority of PH patients (<7% RHC use) but nevertheless, 22% of PH patients post-index had claims for drugs approved for the treatment of pulmonary arterial hypertension (PAH).ConclusionsGroup 3 PH poses a significant clinical and economic burden. Given the low use of RHC and the prevalence of PAH-indicated prescriptions that are not currently approved for Group 3 PH, this study suggests some Group 3 PH patients may not be receiving guideline-recommended treatment.
Highlights
Group 3 pulmonary hypertension (PH) encompasses PH owing to lung diseases and/or hypoxia
Pulmonary hypertension (PH) is a progressive disease that may lead to decreased exercise capacity, right heart failure, and death [1]
PH is clinically defined as a resting mean pulmonary arterial pressure ≥ 25 mmHg measured by right heart catheterization (RHC) [2]
Summary
Group 3 pulmonary hypertension (PH) encompasses PH owing to lung diseases and/or hypoxia. PH is clinically defined as a resting mean pulmonary arterial pressure ≥ 25 mmHg measured by right heart catheterization (RHC) [2]. It can be idiopathic, PH is typically associated with a wide range of Chronic lung disease is associated with a high incidence of PH. Reported prevalence rates of PH in chronic obstructive pulmonary disease (COPD) range from 30% to 70% [4]. Prevalence rates of PH in idiopathic pulmonary fibrosis patients, the most common idiopathic ILD, range from 8% to 84% [5].
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