Contemporary Economic, Hospitalization, and Mortality Burden Among Pulmonary Arterial Hypertension Patients: A Real-World US Claims Data Analysis

Ashwin Ravichandran, Amélie Beaudet, David Lopez, Carolyn R. Lew, Helen Varker, Michelle Jerry, Akshay Muralidhar

https://doi.org/10.1002/pul2.70414

Abstract

This study quantified the recent real-world burden of pulmonary arterial hypertension (PAH) using US real-world data. Adults (18+) with treated PAH were identified from the MarketScan Commercial/Medicare Databases using a claims-based algorithm requiring pulmonary hypertension diagnosis, PAH-specific treatment, and right heart catheterization from January 1, 2017 to August 31, 2024 (earliest treatment claim = index). Patients were followed for ≥ 30 days post-index, overall and stratified by payer and by treatment categories. Subsets of PAH-hospitalized and newly treated patients were also analyzed. Measures included demographics, clinical characteristics, all-cause healthcare utilization/costs, PAH-related hospitalization costs/characteristics, and all-cause mortality. Overall, 2712 treated PAH patients were included (mean age 61.8 years, 68.9% female, 57.9% commercial insurance). During mean 2.2 years of follow-up, mean (median) per-patient-per-year all-cause healthcare costs were $302,014 ($210,888) for commercially-insured patients and $200,581 ($147,706) for Medicare patients. Over half (56.2%) of patients had ≥ 1 all-cause hospitalization, 44.9% had ≥ 1 PAH-related hospitalization, and 31.0% were hospitalized for ≥ 1 complication (thrombosis [14.1%], hemorrhage [12.5%], sepsis [14.9%]). Among the PAH-hospitalized subset (N = 1079), median time to re-hospitalization was 1.2 years. The mean (median) cost per PAH-related hospitalization was $89,799 ($30,224) for commercially-insured and $37,288 ($15,733) for Medicare patients, and 57.2% of hospitalizations required an ICU stay. Among the newly treated subset (N = 2072), 9.7%, 18.6%, and 25.2% of patients died within 1, 2, and 3 years after treatment initiation. Despite recent therapeutic advancements, PAH patients continue to have a substantial clinical and economic burden. These findings highlight ongoing unmet need and underscore the importance of continued monitoring of disease burden as PAH therapies evolve.

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