Examine baseline demographics and clinical characteristics of chronic thromboembolic pulmonary hypertension (CTEPH) patients identified within the Medicare population.
Using Medicare data from 01JAN2013-31DEC2016, CTEPH patients were identified using two different inclusion criteria: (1) Operated (OP)-CTEPH patients with ≥1 claim for pulmonary endarterectomy (PEA) or balloon pulmonary angioplasty (BPA) procedures during the study period and ≥1 pharmacy claim for CTEPH pharmacotherapy (riociquat or macitentan) during the identification period (01JAN2014-31DEC2016). The first CTEPH pharmacotherapy claim date was defined as the index date. (2) Non-operated (NOP)-CTEPH patients had ≥3 months of continuous CTEPH pharmacotherapy (riociquat or macitentan) use; were required to have ≥2 diagnosis claims for pulmonary hypertension and ≥1 diagnosis for pulmonary embolism (PE) on or before the CTEPH pharmacotherapy initiation date. Both cohorts had continuous medical and pharmacy benefits for 12 months pre-index date (baseline period) until ≥1-month post-index date. Patient data were assessed until disenrollment, death, or end of study period.
164 patients were identified (OP-CTEPH: N=50; NOP-CTEPH: N=114). During the baseline period, the mean age was OP-CTEPH=65.2 years; NOP-CTEPH=71.3 years. The percent of female patients was OP-CTEPH=50%; NOP-CTEPH=68%, and the percent of white patients was OP-CTEPH=76%; NOP-CTEPH=75%. The average Charlson comorbidity index score (CCI) was OP-CTEPH=4.4; NOP-CTEPH=4.7. Other than PE, the most frequent comorbidities were systemic hypertension, (OP-CTEPH=86%; NOP-CTEPH=92%), and congestive heart failure (OP-CTEPH=62%; NOP-CTEPH=66%). Seventy-two percent of patients in the OP-CTEPH cohort had their BPA/PEA procedure after the first CTEPH pharmacotherapy treatment, and the median time between index date and PEA/BPA was 184 and 300 days, respectively.
Using real-world data, CTEPH patients were identified using 2 distinct selection criteria. Overall, the NOP-CTEPH group was older, had a higher frequency of co-morbidities, and higher CCI.
Funding source: This project was supported by Actelion pharmaceuticals