Healthcare burden of pulmonary hypertension owing to lung disease and/or hypoxia.

Autor: Heresi GA; Department of Pulmonary and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA. heresig@ccf.org., Platt DM; Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA., Wang W; Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA., Divers CH; Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA., Joish VN; Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA.; Currently at Regeneron, Tarrytown, NY, USA., Teal SA; Bayer Pharma AG, Berlin, Germany., Yu JS; Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA.; Currently at Allergan, Irvine, CA, USA.
Jazyk: angličtina
Zdroj: BMC pulmonary medicine [BMC Pulm Med] 2017 Apr 11; Vol. 17 (1), pp. 58. Date of Electronic Publication: 2017 Apr 11.
DOI: 10.1186/s12890-017-0399-1
Abstrakt: Background: Group 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.
Methods: This 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.
Results: Group 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).
Conclusions: Group 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.
Databáze: MEDLINE
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