Journal Article

Burden of illness in patients with pulmonary hypertension due to interstitial lung disease: a real-world analysis

Heresi, Gustavo, Sketch, Margaret R., Classi, Peter, Spikes, Leslie, Dean, Bonnie, Morland, Kellie, Wu, Benjamin, Lee, Henry, Stafkey-Mailey, Dana

2024

Overview

Background Pulmonary hypertension due to interstitial lung disease (PH-ILD) is associated with high rates of respiratory failure and death. Healthcare resource utilization (HCRU) and cost data are needed to characterize PH-ILD disease burden. Methods A retrospective cohort analysis of the Truven Health MarketScan ® Commercial Claims and Encounters Database and Medicare Supplemental Database between June 2015 to June 2019 was conducted. Patients with ILD were identified and indexed based on their first claim with a PH diagnosis. Patients were required to be 18 years of age on the index date and continuously enrolled for 12-months pre- and post-index. Patients were excluded for having a PH diagnosis prior to ILD diagnosis or the presence of other non-ILD, PH-associated conditions. Treatment patterns, HCRU, and healthcare costs were compared between the 12 months pre- versus 12 months post-index date. Results In total, 122 patients with PH-ILD were included (mean [SD] age, 63.7 [16.6] years; female, 64.8%). The same medication classes were most frequently used both pre- and post-index (corticosteroids: pre-index 43.4%, post-index 53.5%; calcium channel blockers: 25.4%, 36.9%; oxygen: 12.3%, 25.4%). All-cause hospitalizations increased 2-fold, with 29.5% of patients hospitalized pre-index vs. 59.0% post-index ( P  < 0.0001). Intensive care unit (ICU) utilization increased from 6.6 to 17.2% ( P  = 0.0433). Mean inpatient visits increased from 0.5 (SD, 0.9) to 1.1 (1.3) ( P  < 0.0001); length of stay (days) increased from 5.4 (5.9) to 7.5 (11.6) ( P  < 0.0001); bed days from 2.5 (6.6) to 8.0 (16.3) ( P  < 0.0001); ICU days from 3.8 (2.3) to 7.0 (13.2) ( P  = 0.0362); and outpatient visits from 24.5 (16.8) to 32.9 (21.8) ( P  < 0.0001). Mean (SD) total all-cause healthcare costs increased from $43,201 ($98,604) pre-index to $108,387 ($190,673) post-index ( P  < 0.0001); this was largely driven by hospitalizations (which increased from a mean [SD] of $13,133 [$28,752] to $63,218 [$75,639] [ P  < 0.0001]) and outpatient costs ($16,150 [$75,639] to $25,604 [$93,964] [ P  < 0.0001]). Conclusion PH-ILD contributes to a high HCRU and cost burden. Timely identification, management, and treatment are needed to mitigate the clinical and economic consequences of PH-ILD development and progression.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Aged, 80 and over / Ambulatory care / Care and treatment / Causes of / Complications and side effects / Corticosteroids / Cost / Cost of Illness / Critical Care Medicine / Database analysis / Databases, Factual / Diagnosis / Drug therapy / Evaluation / FDA approval / Female / Health care / Health Care Costs - statistics & numerical data / Health care expenditures / Health care policy / Health insurance / Healthcare resource utilization / Hospitalization / Hospitalization - economics / Hospitalization - statistics & numerical data / Humans / Hypertension / Hypertension, Pulmonary - economics / Hypertension, Pulmonary - epidemiology / Hypertension, Pulmonary - therapy / Intensive / Internal Medicine / Interstitial lung disease / Laboratories / Lung diseases / Lung diseases, Interstitial / Lung Diseases, Interstitial - complications / Lung Diseases, Interstitial - economics / Lung transplants / Male / Medical care, Cost of / Medical claims / Medicare / Medicine / Medicine & Public Health / Middle Aged / Patient Acceptance of Health Care - statistics & numerical data / Patients / Pneumology/Respiratory System / Pulmonary arteries / Pulmonary fibrosis / Pulmonary hypertension / Quality of life / Resource utilization / Retrospective Studies / Steroids / United States