Societal Costs Associated With Pulmonary Arterial Hypertension Subgroups : A Study Utilizing Linked National Registries
(2025) In Pulmonary Circulation 15(2).- Abstract
Pulmonary arterial hypertension (PAH) is a heterogenic diagnosis including idiopathic and hereditary PAH (IPAH/HPAH) and groups associated to connective tissue disease (APAH-CTD) and congenital heart disease (APAH-CHD). Pre- and post-diagnosis societal costs in PAH subgroups are not well known. By linking Swedish national databases, societal costs in a national PAH cohort 5 years before and 5 years after diagnosis were estimated and compared to an age, sex, and geographically matched control group (1:5 match). Incident patients diagnosed 2008–2019 were included (patient/control; IPAH/HPAH = 393/1965, APAH-CTD = 261/1305, APAH-CHD = 89/445). Pre-diagnosis mean societal costs were 2.9, 3.4, and 4.3 times higher for IPAH/HPAH, APAH-CTD and... (More)
Pulmonary arterial hypertension (PAH) is a heterogenic diagnosis including idiopathic and hereditary PAH (IPAH/HPAH) and groups associated to connective tissue disease (APAH-CTD) and congenital heart disease (APAH-CHD). Pre- and post-diagnosis societal costs in PAH subgroups are not well known. By linking Swedish national databases, societal costs in a national PAH cohort 5 years before and 5 years after diagnosis were estimated and compared to an age, sex, and geographically matched control group (1:5 match). Incident patients diagnosed 2008–2019 were included (patient/control; IPAH/HPAH = 393/1965, APAH-CTD = 261/1305, APAH-CHD = 89/445). Pre-diagnosis mean societal costs were 2.9, 3.4, and 4.3 times higher for IPAH/HPAH, APAH-CTD and APAH-CHD patients, respectively, than controls. Post-diagnosis, mean costs had increased 3.1, 2.0, and 1.6 times further for IPAH/HPAH, APAH-CTD and APAH-CHD respectively, while it decreased in all control groups. Main cost driver pre-diagnosis were indirect costs (productivity loss) in both patient and control groups, however, 2.7–4.5 times higher in the patient groups. Post-diagnosis, the main cost driver for all groups were health care costs (in- and outpatient-care, drugs) that had increased 7.8, 5.4 and 6.8 times for IPAH/HPAH, APAH-CTD and APAH-CHD, respectively. Corresponding increase for controls were 17%–48%. For the PAH groups, drug treatment accounted for 70%–81% of the direct costs, while hospitalizations were the main driver for the control groups. In conclusion, PAH was associated with large societal costs. Pre-diagnosis, APAH-CHD had the highest societal costs, both in relation to their control group and compared to the other patient groups. Post-diagnosis, highest societal costs were seen in IPAH/HPAH.
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- author
- Kjellström, Barbro LU ; Ivarsson, Bodil LU ; Husberg, Magnus ; Levin, Lars Åke and Bernfort, Lars
- organization
- publishing date
- 2025-04
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- health care resource utilization, national registry, productivity loss, pulmonary hypertension
- in
- Pulmonary Circulation
- volume
- 15
- issue
- 2
- article number
- e70074
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- scopus:105003189833
- pmid:40248212
- ISSN
- 2045-8932
- DOI
- 10.1002/pul2.70074
- language
- English
- LU publication?
- yes
- id
- f097c889-08ec-4386-bd8f-0ddde5bc1963
- date added to LUP
- 2025-08-13 12:27:02
- date last changed
- 2025-08-14 03:00:07
@article{f097c889-08ec-4386-bd8f-0ddde5bc1963,
abstract = {{<p>Pulmonary arterial hypertension (PAH) is a heterogenic diagnosis including idiopathic and hereditary PAH (IPAH/HPAH) and groups associated to connective tissue disease (APAH-CTD) and congenital heart disease (APAH-CHD). Pre- and post-diagnosis societal costs in PAH subgroups are not well known. By linking Swedish national databases, societal costs in a national PAH cohort 5 years before and 5 years after diagnosis were estimated and compared to an age, sex, and geographically matched control group (1:5 match). Incident patients diagnosed 2008–2019 were included (patient/control; IPAH/HPAH = 393/1965, APAH-CTD = 261/1305, APAH-CHD = 89/445). Pre-diagnosis mean societal costs were 2.9, 3.4, and 4.3 times higher for IPAH/HPAH, APAH-CTD and APAH-CHD patients, respectively, than controls. Post-diagnosis, mean costs had increased 3.1, 2.0, and 1.6 times further for IPAH/HPAH, APAH-CTD and APAH-CHD respectively, while it decreased in all control groups. Main cost driver pre-diagnosis were indirect costs (productivity loss) in both patient and control groups, however, 2.7–4.5 times higher in the patient groups. Post-diagnosis, the main cost driver for all groups were health care costs (in- and outpatient-care, drugs) that had increased 7.8, 5.4 and 6.8 times for IPAH/HPAH, APAH-CTD and APAH-CHD, respectively. Corresponding increase for controls were 17%–48%. For the PAH groups, drug treatment accounted for 70%–81% of the direct costs, while hospitalizations were the main driver for the control groups. In conclusion, PAH was associated with large societal costs. Pre-diagnosis, APAH-CHD had the highest societal costs, both in relation to their control group and compared to the other patient groups. Post-diagnosis, highest societal costs were seen in IPAH/HPAH.</p>}},
author = {{Kjellström, Barbro and Ivarsson, Bodil and Husberg, Magnus and Levin, Lars Åke and Bernfort, Lars}},
issn = {{2045-8932}},
keywords = {{health care resource utilization; national registry; productivity loss; pulmonary hypertension}},
language = {{eng}},
number = {{2}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Pulmonary Circulation}},
title = {{Societal Costs Associated With Pulmonary Arterial Hypertension Subgroups : A Study Utilizing Linked National Registries}},
url = {{http://dx.doi.org/10.1002/pul2.70074}},
doi = {{10.1002/pul2.70074}},
volume = {{15}},
year = {{2025}},
}