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.
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.
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.
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).
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.
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
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- Healthcare burden of pulmonary hypertension owing to lung disease and/or hypoxia
Gustavo A. Heresi
David M. Platt
Christine H. Divers
Vijay N. Joish
Simon A. Teal
Justin S. Yu
- BioMed Central
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