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首页> 美国卫生研究院文献>Pulmonary Circulation >Treatment patterns healthcare resource utilization and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database
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Treatment patterns healthcare resource utilization and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database

机译：美国真实数据库中的肺动脉高压患者的治疗模式医疗资源利用和医疗费用

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Several new medications for pulmonary arterial hypertension (PAH) have recently been introduced; however, current real-world data regarding US patients with PAH are limited. We conducted a retrospective administrative claims study to examine PAH treatment patterns and summarize healthcare utilization and costs among patients with newly diagnosed PAH treated in US clinical practice. Patients newly treated for PAH from 1 January 2010 to 31 March 2015 were followed for ≥12 months. Patient characteristics, treatment patterns, healthcare resource utilization, and costs were described. Adherence (proportion of days covered), persistence (months until therapy discontinuation/modification), and the probability of continuing the index regimen were analyzed by index regimen cohort (monotherapy versus combination therapy). Of 1637 eligible patients, 93.8% initiated treatment with monotherapy and 6.2% with combination therapy. The most common index regimen was phosphodiesterase type 5 inhibitor (PDE-5I) monotherapy (70.0% of patients). A total of 581 patients (35.5%) modified their index regimen during the study. Most patients (55.4%) who began combination therapy did so on or within six months of the index date. Endothelin receptor agonists (ERAs) and combination therapies were associated with higher adherence than PDE-5Is and monotherapies, respectively. Healthcare utilization was substantial across the study population, with costs in the combination therapy cohort more than doubling from baseline to follow-up. The majority of patients were treated with monotherapies (most often, PDE-5Is), despite combination therapies and ERAs being associated with higher medication adherence. Index regimen adjustments occurred early and in a substantial proportion of patients, suggesting that inadequate clinical response to monotherapies may not be uncommon.
机译：最近已经引入了几种新的肺动脉高压药物（PAH）。但是，有关美国PAH患者的当前实际数据有限。我们进行了一项回顾性行政索赔研究，以检查PAH的治疗方式，并总结在美国临床实践中接受过新诊断的PAH患者的医疗保健利用率和费用。自2010年1月1日至2015年3月31日新接受PAH治疗的患者，随访时间≥12个月。描述了患者的特征，治疗方式，医疗资源利用和成本。通过指标方案队列（单一疗法与联合疗法）分析依从性（涵盖天数的比例），持久性（直到治疗终止/修改的月数）以及继续采用索引方案的可能性。在1637名合格患者中，有93.8％的患者开始采用单一疗法，而6.2％的患者开始联合疗法。最常见的索引方案是5型磷酸二酯酶抑制剂（PDE-5I）单一疗法（占患者的70.0％）。在研究过程中，共有581名患者（35.5％）修改了他们的索引方案。大多数开始联合治疗的患者（55.4％）在转诊日期或之后的六个月内开始接受联合治疗。内皮素受体激动剂（ERAs）和联合疗法分别比PDE-5Is和单一疗法具有更高的依从性。在整个研究人群中，医疗保健利用率很高，从基线到随访，联合治疗组的费用增加了一倍以上。尽管联合疗法和ERA与更高的药物依从性相关，但大多数患者仍接受单一疗法（最常见的是PDE-5I）。索引方案的调整是在早期进行的，并且在很大比例的患者中进行，这表明对单一疗法的临床反应不足可能并不罕见。

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