Initial Treatment and Cost of Care in Pulmonary Hypertension
A new study finds that the first treatment chosen to treat PAH may help mitigate the burden of all-cause cost of care.
Treatment options for PAH are evloving, yet patient prognosis remains poor. PAH also confers a heavy ecomomic burden related to cost of drugs, hospitalizations, and comorobidities. There is research that suggests initial treatment with PAH-specific medications (vs combinations of agents) may decrease healthcare utilization. Could this strategy tranlsate into reduced overall healthcare costs to treat PAH?Â
Choice of Initial Treatment and Cost of Care in Pulmonary Arterial Hypertension
Few studies have looked at prognostic utility of hemodynamic variables after starting PAH therapy.
This new study looked at costs of PAH treatment 6 months before and 6 months after starting PAH-specific therapy.
There was a significant drop in overall hospitalizations after starting PAH-specific therapy (p<.001) and a >50% drop in PAH-related hospitalizations after starting PAH-specific therapy (p<.001).
A significant drop was seen in non-Rx all-cause medical costs after starting PAH-specific therapy that was attributed to decreased hospitalization costs. Pharmacy costs, however, increased significinatly. But, overall, all-cause total healthcare costs remained about the same.
Decreased utilization costs may offset large upfront pharmacy costs and longer time on therapy (> 6 months) may yield additional savings.
Before the 2015 AMBITION study, initial monotherapy was recommended, using dose escalation as needed. AMBITION results supported initiating combination therapy and after 2015, the European guidelines on PAH also recommended initial combination therapy.
- Retrospective administrative claims study showed hospitalizations and related costs dropped significantly after starting PAH-specific therapy
- Pharmacy costs increased significantly, so that all-cause total healthcare costs remained the same
- Decreased costs of healthcare utilization can offset large upfront pharmacy costs
- More studies needed to evaluate practice changes/costs given post-AMBITION recommendations advising initial combination therapy