PRS29 EVALUATION OF THE REAL-WORLD INCREMENTAL COST BURDEN OF NEWLY TREATED PAH IN THE US

Abstract

To estimate healthcare resource utilization and direct costs among newly treated PAH patients in comparison to a control group of non-PAH patients. The Optum ClinformaticsTM Data Mart was used to identify adult treatment-naïve PAH patients who initiated an oral PAH-specific medication between 1/1/2013 and 6/30/2016, with the earliest claim defined as the index date. PAH patients were matched at a 1:5 ratio to non-PAH control patients by multidimensional matching. Control patients were assigned a random index date close to the index date of their matched counterpart. Patients were required to have continuous enrollment 12 months prior to (baseline period) and after (follow-up period) the index date, as well as ≥1 PAH diagnosis and no diagnoses of WHO Group 4 Pulmonary hypertension or claims for PAH-specific drugs during the baseline period. All-cause healthcare resource utilization and costs during the baseline and follow-up periods were measured and compared between the matched cohorts. 1,153 newly treated PAH patients and 5,765 matched non-PAH controls were identified with a mean±SD age of 68.5±13.0; 65.6% were female and 72.7% had Medicare coverage. Baseline medical and pharmacy costs were $65,101 vs. $4,056 and $6,367 vs. $992, respectively, yielding total costs of $71,468 vs. $5,048 for the matched PAH and non-PAH patients. Baseline medical costs were primarily due to inpatient ($34,065 vs. $1,429) and outpatient ($29,958 vs. $2,398) care. During the follow-up period, mean inpatient costs were $22,782 vs. $1,174, pharmacy costs were $42,192 vs. $876, outpatient costs were $35,499 vs. $2,452 and total costs were $101,607 vs. $4,702 for PAH and non-PAH patients, respectively. The real-world cost burden for PAH is high. There are modest increases in total healthcare spending during the first 12 months after initiating PAH treatment, where the increased PAH-related pharmacy costs were partially offset by decreased inpatient utilization.