Demographics, clinical characteristics, health resource utilization and cost of chronic thromboembolic pulmonary hypertension patients: retrospective results from six European countries

BMC Health Services Research

Mirko Sikirica⁵  Jenny Berg¹  Anja Gabriel³  Marius M Hoeper⁸  Joanna Pepke-Zaba²  Carmine Dario Vizza⁶  David Pittrow⁴  Bernd Schweikert⁷ 

[1] OptumInsight, Stockholm, Sweden;Papworth Hospital NHS Trust, Cambridge, United Kingdom;Bayer Pharma AG, Wuppertal, Germany;Institute for Clinical Pharmacology, Technical University, Dresden, Germany;Bayer Pharma AG, Berlin, Germany;Department of Cardiovascular and Respiratory Science, School of Medicine, University of Rome “Sapienza”, Rome, Italy;OptumInsight, Konrad-Zuse-Platz 11, D- 81829 Munich, Germany;Hanover Medical School, Hanover, Germany

关键词: Cost;    Treatment;    Pulmonary hypertension;    Chart review;    Retrospective;   

Others  :  1130828
DOI  :  10.1186/1472-6963-14-246

 received in 2013-06-20, accepted in 2014-05-30,  发布年份 2014

【 摘 要 】

Background

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) results from incomplete resolution of a pulmonary embolus, leading to pulmonary hypertension and progressive right heart failure and death. We aimed to describe the demographics, treatment patterns, health resource utilization and related costs of patients with CTEPH.

Methods

In specialized PH centres across six European countries, medical charts of CTEPH patients on PH medication were retrospectively extracted (chart review between 2006 and 2009). Resource utilization was valued using country-specific unit costs. Descriptive statistical analyses were performed.

Results

Twenty-one hospitals documented 119 consecutive CTEPH patients over an average of 25.4 months. Patients were inoperable (83.9%) or persistent after surgery (16.0%) with mean age 67.5 ± 12.3 years, 61% were female. The average 6-minute walking distance was 298 ± 120 meters, and NYHA class II/III/IV was 27/59/14%. At baseline, 59.7% patients received endothelin receptor antagonist, 34.4% phosphodiesterase-5 inhibitors, and 5.8% prostacyclin. Adding a second PH medication was the most common regimen change. CTEPH patients experienced 1.8 ± 2.2 hospitalizations per year accounting for 14.8 ± 26.1 days in hospital. Patients paid on average 2.8 office visits per year to their general practitioner and 1.3 visits to a specialist. Unadjusted annual mortality rate was 6.0%. Annual cost of PH specific medication was the predominant economic factor averaging € 36,768 per year. Costs for hospitalizations (€ 4,496) and concomitant medications (€ 2,510) were substantially lower. Other health care resource items only accounted for marginal additional costs.

Conclusion

CTEPH patients are characterised by substantial morbidity and mortality. Health care utilisation, predominantly due to off-label use of PH drugs, is significant.

【 授权许可】

   
2014 Schweikert et al.; licensee BioMed Central Ltd.

【 图 表 】

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