Cargando…

Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database

Several new medications for pulmonary arterial hypertension (PAH) have recently been introduced; however, current real-world data regarding US patients with PAH are limited. We conducted a retrospective administrative claims study to examine PAH treatment patterns and summarize healthcare utilizatio...

Descripción completa

Detalles Bibliográficos
Autores principales: Studer, Sean, Hull, Michael, Pruett, Janis, Koep, Eleena, Tsang, Yuen, Drake, William
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6432690/
https://www.ncbi.nlm.nih.gov/pubmed/30421652
http://dx.doi.org/10.1177/2045894018816294
_version_ 1783406183775731712
author Studer, Sean
Hull, Michael
Pruett, Janis
Koep, Eleena
Tsang, Yuen
Drake, William
author_facet Studer, Sean
Hull, Michael
Pruett, Janis
Koep, Eleena
Tsang, Yuen
Drake, William
author_sort Studer, Sean
collection PubMed
description Several new medications for pulmonary arterial hypertension (PAH) have recently been introduced; however, current real-world data regarding US patients with PAH are limited. We conducted a retrospective administrative claims study to examine PAH treatment patterns and summarize healthcare utilization and costs among patients with newly diagnosed PAH treated in US clinical practice. Patients newly treated for PAH from 1 January 2010 to 31 March 2015 were followed for ≥12 months. Patient characteristics, treatment patterns, healthcare resource utilization, and costs were described. Adherence (proportion of days covered), persistence (months until therapy discontinuation/modification), and the probability of continuing the index regimen were analyzed by index regimen cohort (monotherapy versus combination therapy). Of 1637 eligible patients, 93.8% initiated treatment with monotherapy and 6.2% with combination therapy. The most common index regimen was phosphodiesterase type 5 inhibitor (PDE-5I) monotherapy (70.0% of patients). A total of 581 patients (35.5%) modified their index regimen during the study. Most patients (55.4%) who began combination therapy did so on or within six months of the index date. Endothelin receptor agonists (ERAs) and combination therapies were associated with higher adherence than PDE-5Is and monotherapies, respectively. Healthcare utilization was substantial across the study population, with costs in the combination therapy cohort more than doubling from baseline to follow-up. The majority of patients were treated with monotherapies (most often, PDE-5Is), despite combination therapies and ERAs being associated with higher medication adherence. Index regimen adjustments occurred early and in a substantial proportion of patients, suggesting that inadequate clinical response to monotherapies may not be uncommon.
format Online
Article
Text
id pubmed-6432690
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-64326902019-03-28 Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database Studer, Sean Hull, Michael Pruett, Janis Koep, Eleena Tsang, Yuen Drake, William Pulm Circ Research Article Several new medications for pulmonary arterial hypertension (PAH) have recently been introduced; however, current real-world data regarding US patients with PAH are limited. We conducted a retrospective administrative claims study to examine PAH treatment patterns and summarize healthcare utilization and costs among patients with newly diagnosed PAH treated in US clinical practice. Patients newly treated for PAH from 1 January 2010 to 31 March 2015 were followed for ≥12 months. Patient characteristics, treatment patterns, healthcare resource utilization, and costs were described. Adherence (proportion of days covered), persistence (months until therapy discontinuation/modification), and the probability of continuing the index regimen were analyzed by index regimen cohort (monotherapy versus combination therapy). Of 1637 eligible patients, 93.8% initiated treatment with monotherapy and 6.2% with combination therapy. The most common index regimen was phosphodiesterase type 5 inhibitor (PDE-5I) monotherapy (70.0% of patients). A total of 581 patients (35.5%) modified their index regimen during the study. Most patients (55.4%) who began combination therapy did so on or within six months of the index date. Endothelin receptor agonists (ERAs) and combination therapies were associated with higher adherence than PDE-5Is and monotherapies, respectively. Healthcare utilization was substantial across the study population, with costs in the combination therapy cohort more than doubling from baseline to follow-up. The majority of patients were treated with monotherapies (most often, PDE-5Is), despite combination therapies and ERAs being associated with higher medication adherence. Index regimen adjustments occurred early and in a substantial proportion of patients, suggesting that inadequate clinical response to monotherapies may not be uncommon. SAGE Publications 2018-11-13 /pmc/articles/PMC6432690/ /pubmed/30421652 http://dx.doi.org/10.1177/2045894018816294 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Research Article
Studer, Sean
Hull, Michael
Pruett, Janis
Koep, Eleena
Tsang, Yuen
Drake, William
Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database
title Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database
title_full Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database
title_fullStr Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database
title_full_unstemmed Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database
title_short Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database
title_sort treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world us database
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6432690/
https://www.ncbi.nlm.nih.gov/pubmed/30421652
http://dx.doi.org/10.1177/2045894018816294
work_keys_str_mv AT studersean treatmentpatternshealthcareresourceutilizationandhealthcarecostsamongpatientswithpulmonaryarterialhypertensioninarealworldusdatabase
AT hullmichael treatmentpatternshealthcareresourceutilizationandhealthcarecostsamongpatientswithpulmonaryarterialhypertensioninarealworldusdatabase
AT pruettjanis treatmentpatternshealthcareresourceutilizationandhealthcarecostsamongpatientswithpulmonaryarterialhypertensioninarealworldusdatabase
AT koepeleena treatmentpatternshealthcareresourceutilizationandhealthcarecostsamongpatientswithpulmonaryarterialhypertensioninarealworldusdatabase
AT tsangyuen treatmentpatternshealthcareresourceutilizationandhealthcarecostsamongpatientswithpulmonaryarterialhypertensioninarealworldusdatabase
AT drakewilliam treatmentpatternshealthcareresourceutilizationandhealthcarecostsamongpatientswithpulmonaryarterialhypertensioninarealworldusdatabase