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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Pulmonary Medicine 1/2017

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

Zeitschrift:
BMC Pulmonary Medicine > Ausgabe 1/2017
Autoren:
Gustavo A. Heresi, David M. Platt, Wenyi Wang, Christine H. Divers, Vijay N. Joish, Simon A. Teal, Justin S. Yu
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12890-017-0399-1) contains supplementary material, which is available to authorized users.
Partial results from this study were presented at the following conferences: • American Thoracic Society (ATS) International Conference, May 15–20, 2015, Denver, CO. • International Society of Pharmacoeconomics and Outcomes Research (ISPOR) 20th Annual International Meeting, May 16–20, 2015, Philadelphia, PA.

Abstract

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.
Zusatzmaterial
Additional file 1: Group 3 Pulmonary Hypertension Matched to Diagnostic Claims Diagnosis Codes. Table containing the ICD-9-CM diagnostic claim codes matched to Group 3 PH subgroups by lung disease. (PDF 200 kb)
12890_2017_399_MOESM1_ESM.pdf
Additional file 2: WHO Group 2, 4 and 5 Pulmonary Hypertension Classifications Mapped to Diagnostic/Procedure Codes. (PDF 97 kb)
12890_2017_399_MOESM2_ESM.pdf
Additional file 3: Annual Per-Patient All-Cause Quartile Medical Costs. (PDF 122 kb)
12890_2017_399_MOESM3_ESM.pdf
Additional file 4: Annual Per Patient Respiratory-Related Quartile Medical Costs. (PDF 117 kb)
12890_2017_399_MOESM4_ESM.pdf
Literatur
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