04 February 2019 by Michele Cole

Baseline demographics and clinical characteristics of chronic thromboembolic pulmonary hypertension patients within medicare population


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


Key Contributors

Talal Dahhan MD MSEd 1, Michele Cole PharmD MS 2, Cassandra Lickert MD 2, Lin Xie MA MS 3,4, Laurence Leber PharmD, MPH 2, Huseyin Yuce PhD 4, Daniel Rosenberg PhD 2, Wassim H. Fares MD MSc 2, William Drake PharmD 2 : 1 Pulmonary Vascular Disease Center, Division of Pulmonary, Allergy and Critical Care Medicine, Duke University, Durham, NC. 2 Actelion Pharmaceuticals 3 STATinMED Research, Ann Arbor, MI 4 New York City College of Technology (CUNY), New York, NY

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