Hospital burden of pulmonary arterial hypertension in France

Abstract

Background & aimsPulmonary arterial hypertension is a severe disease associated with frequent hospitalisations. This retrospective analysis of the French medical information PMSI-MSO database aimed to describe incident cases of patients with pulmonary arterial hypertension hospitalised in France in 2013 and to document associated hospitalisation costs from the national health insurance perspective.MethodsCases of pulmonary arterial hypertension were identified using a diagnostic algorithm. All cases hospitalised in 2013 with no hospitalisation the previous two years were retained. All hospital stays during the year following the index hospitalisation were extracted, and classified as incident stays, monitoring stays or stays due to disease worsening. Costs were attributed from French national tariffs.Results384 patients in France were hospitalised with incident pulmonary arterial hypertension in 2013. Over the following twelve months, patients made 1,271 stays related to pulmonary arterial hypertension (415 incident stays, 604 monitoring stays and 252 worsening stays). Mean age was 59.6 years and 241 (62.8%) patients were women. Liver disease and connective tissue diseases were documented in 62 patients (16.1%) each. Thirty-one patients (8.1%) died during hospitalisation and four (1.0%) received a lung/heart-lung transplantation. The total annual cost of these hospitalisations was € 3,640,382. € 2,985,936 was attributable to standard tariffs (82.0%), € 463,325 to additional ICU stays (12.7%) and € 191,118 to expensive drugs (5.2%). The mean cost/stay was € 2,864, ranging from € 1,282 for monitoring stays to € 7,285 for worsening stays.ConclusionsAlthough pulmonary arterial hypertension is rare, it carries a high economic burden.

Societal costs associated with pulmonary arterial hypertension: A study utilizing linked national registries

“…That a debilitating disease like PAH have high HCRU after diagnosis is neither surprising nor unknown, 9 , 10 , 11 , 12 , 15 , 16 , 17 however, the costs for society before diagnosis is less studied 10 , 17 , 31 , 32 and the magnitude of productivity loss has not been shown before. Hospitalizations as a substantial cost driver after the PAH diagnosis 10 , 11 , 15 , 16 , 17 was confirmed by the present study and, importantly, productivity loss was found to be equally costly.…”

“…1 , 6 , 7 , 8 This, together with disease targeted medical treatment, makes the economic burden of PAH substantial. 9 , 10 , 11 , 12 Estimations of the societal economic burden of PAH vary due to differences in data sources, selection of subjects, and cost components as well as changes in available treatments and treatment strategies over time. 12 Studies investigating indirect costs of PAH before and after diagnosis are scarce.…”

Critical Care Management of Decompensated Right Heart Failure in Pulmonary Arterial Hypertension Patients – An Ongoing Approach

“…The incidence, prevalence, and phenotype of PAH display differences between studies, registries, presumably related to the design, structure biases, ranging from 2 to 52 cases per million inhabitants [1,[26][27][28][29][30].…”

Predicting Risk of 1-Year Hospitalization Among Patients with Pulmonary Arterial Hypertension

“…Pulmonary arterial hypertension (PAH) is a rare disease characterized by progressive pulmonary vascular resistance, eventual right heart failure, and high mortality [1]. It is frequently associated with hospitalization, an event indicative of disease progression and decreased survival [2][3][4]. A study using the Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL Registry) reported that nearly 60% of patients newly diagnosed with PAH (N = 862) were hospitalized over a 3-year time period, with over 50% of the hospitalizations being PAH-related [3].…”