Pulmonary Vascular Disease |

Guideline Based Estimates of Diagnostic and Treatment-Related Resource Use and Costs of a Typical Pulmonary Arterial Hypertension Patient to U.S. Health Plan FREE TO VIEW

Vijay Joish, PhD; Christine Divers, PhD; Chakkarin CBurudpakdee, PharmD; Anshul Shah, MS; Stephen Mathai, MD
Author and Funding Information

Bayer HealthCare Pharmaceuticals, Wayne, NJ

Chest. 2014;145(3_MeetingAbstracts):510A. doi:10.1378/chest.1808915
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SESSION TITLE: Pulmonary Hypertension Posters II

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: To outline the resource use and costs a U.S. health plan can anticipate during the evaluation and first year of treatment of a PAH patient.

METHODS: An interactive economic model was developed based on the 2009 diagnostic and treatment guidelines for pulmonary hypertension published by the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association. Model assumptions were as follows: a) patient and physician are 100% adherent to diagnostics and treatments; b) patient undergoes all diagnostic tests before being diagnosed within a 12-month period; c) patient has stable disease over the 12-month treatment period; d) first intra-venous infusion/subcutaneous drug is administered by a provider and the subsequent at home and e) guideline recommended disease management costs were included however cost of pharmacotherapy monitoring and adverse events were not included. The model allowed for estimating the resource and cost of treatment for three types of PAH patient based on vaso-reactive test: positive, negative-low risk, negative-high risk. Unit costs for each resource use were derived from publically available sources that included MediSpan’s master drug database, Medicare 2013 physician fee schedule, and Medicare clinical diagnostic laboratory fee schedule.

RESULTS: Diagnostic costs were $6,378.78 per PAH patient based on ACCF guidelines. Annual pharmacotherapy costs were $2,456.66 for positive, $1,206.24 for negative-low risk, and $30,174.31 for negative-high risk patients. Annual disease management costs were highest for a high risk patient ($7,529.58) while costs were similar for a low-risk and a vaso-reactive positive patient ($3,436.81).

CONCLUSIONS: This is the first study that outlines the anticipated resource use and cost of a single PAH patient from a U.S. health plan perspective.

CLINICAL IMPLICATIONS: Pulmonary arterial hypertension (PAH) is a progressive disease that leads to right heart failure and death. While there remains no cure for PAH, advances in management have increased survival in patients with this devastating disease. However, little is known about the cost burden of the initial evaluation and treatment of PAH patients.

DISCLOSURE: Vijay Joish: Employee: employee of bayer sponsor of the study Christine Divers: Employee: Employee of Bayer Chakkarin CBurudpakdee: Consultant fee, speaker bureau, advisory committee, etc.: paid consultant of Bayer Anshul Shah: Consultant fee, speaker bureau, advisory committee, etc.: paid consultant of Bayer Stephen Mathai: Consultant fee, speaker bureau, advisory committee, etc.: Paid consultant of Bayer, sponsor of this study

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