Societal Costs Associated With Pulmonary Arterial Hypertension Subgroups: A Study Utilizing Linked National Registries
ABSTRACT Pulmonary arterial hypertension (PAH) is a heterogenic diagnosis including idiopathic and hereditary PAH (IPAH/HPAH) and groups associated to connective tissue disease (APAH‐CTD) and congenital heart disease (APAH‐CHD). Pre‐ and post‐diagnosis societal costs in PAH subgroups are not well kn...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-04-01
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| Series: | Pulmonary Circulation |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/pul2.70074 |
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| Summary: | ABSTRACT Pulmonary arterial hypertension (PAH) is a heterogenic diagnosis including idiopathic and hereditary PAH (IPAH/HPAH) and groups associated to connective tissue disease (APAH‐CTD) and congenital heart disease (APAH‐CHD). Pre‐ and post‐diagnosis societal costs in PAH subgroups are not well known. By linking Swedish national databases, societal costs in a national PAH cohort 5 years before and 5 years after diagnosis were estimated and compared to an age, sex, and geographically matched control group (1:5 match). Incident patients diagnosed 2008–2019 were included (patient/control; IPAH/HPAH = 393/1965, APAH‐CTD = 261/1305, APAH‐CHD = 89/445). Pre‐diagnosis mean societal costs were 2.9, 3.4, and 4.3 times higher for IPAH/HPAH, APAH‐CTD and APAH‐CHD patients, respectively, than controls. Post‐diagnosis, mean costs had increased 3.1, 2.0, and 1.6 times further for IPAH/HPAH, APAH‐CTD and APAH‐CHD respectively, while it decreased in all control groups. Main cost driver pre‐diagnosis were indirect costs (productivity loss) in both patient and control groups, however, 2.7–4.5 times higher in the patient groups. Post‐diagnosis, the main cost driver for all groups were health care costs (in‐ and outpatient‐care, drugs) that had increased 7.8, 5.4 and 6.8 times for IPAH/HPAH, APAH‐CTD and APAH‐CHD, respectively. Corresponding increase for controls were 17%–48%. For the PAH groups, drug treatment accounted for 70%–81% of the direct costs, while hospitalizations were the main driver for the control groups. In conclusion, PAH was associated with large societal costs. Pre‐diagnosis, APAH‐CHD had the highest societal costs, both in relation to their control group and compared to the other patient groups. Post‐diagnosis, highest societal costs were seen in IPAH/HPAH. |
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| ISSN: | 2045-8940 |