Key result
PAH and CTEPH impose substantial economic burden driven by disability pensions and drug costs reaching ~67%.
Why the study?
PAH and CTEPH are rare, severe subtypes of pulmonary hypertension significantly impacting patients' lives, motivating an analysis of their total societal costs in Finland.
Observational (n=424)
PAH and CTEPH impose a substantial economic burden driven largely by drug costs and disability, though costs are significantly lower for CTEPH patients who undergo pulmonary endarterectomy.
May inform resource allocation in PAH/CTEPH; extends burden estimates but leaves open cost-reduction strategies.
• PAH and CTEPH cause a substantial economic burden on patients and society, with costs starting to increase years prior to diagnosis. • Care costs for PAH were significantly higher than for CTEPH over the five years post-diagnosis. • For CTEPH patients, those who underwent PEA surgery had significantly lower overall costs compared to non-operated patients. • 70% of working-age PAH patients were on disability pension five years post- diagnosis, indicating significant indirect costs and societal impacts. Given that pulmonary arterial hypertension (PAH) and chronic thromboembolic hypertension (CTEPH) are rare yet severe subtypes of pulmonary hypertension significantly impacting patients’ lives, this study analyzed the total societal costs of these conditions in Finland. PAH (n = 247) and CTEPH (n = 177) patients diagnosed between 2008 and 2019 were analyzed for primary and specialty outpatient visits, emergency visits, hospitalizations, home and institutional care, sick leaves, disability pensions, and drug costs for 5 years before and after diagnosis. In PAH and CTEPH, annual specialty care number of outpatient visits increased from 3.8 and 3.3 (5 years before diagnosis) to 13.8 and 9.5 one-year post-diagnosis, then decreased to 9.2 and 4.0 at 5 years post-diagnosis. Annual inpatient days rose from 2.8 and 2.7 to 16.1 and 19.7 pre-diagnosis, then fell to 10.2 and 3.5 post-diagnosis, respectively. Within 5 years post-diagnosis, in working-age 70 % PAH and 42 % CTEPH patients received disability pensions. Drug therapy accounted for most costs (67 % in PAH and 60 % in CTEPH), followed by inpatient care, disability pensions, and outpatient care. Total costs were significantly lower for CTEPH, especially after pulmonary endarterectomy. Among PAH subtypes, the highest costs were in patients with PAH associated with connective tissue diseases. PAH and CTEPH cause a significant economic burden on patients and society with considerable differences depending on the PAH subtype and whether the patient has undergone PEA operation or not.
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Pentikäinen et al. (2024) conducted an observational in Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) (n=424). Diagnosis of PAH or CTEPH was evaluated on Total societal costs including healthcare utilization, sick leaves, disability pensions, and drug costs. PAH and CTEPH impose a substantial economic burden, driven primarily by drug therapy (67% of costs in PAH, 60% in CTEPH) and high rates of disability pensions at 5 years post-diagnosis.
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