The economic burden of chronic thromboembolic pulmonary hypertension in Russian Federation

Abstract

Aim. The aim of current study was to estimate the economic burden of the chronic thromboembolic pulmonary hypertension (CTEPH) in Russia based on patient registry. Materials and methods. Cost of illness study was based on data derived from CTEPH patient registry that was developed at the Division of hypertension of FSBI “National Medical Research Center of Cardiology”. Demographic and clinical patient characteristics were analyzed with descriptive statistic methods. Cost of illness study was performed from the state perspective and with bottom-up approach. Bootstrapping was used for calculation of average costs per patient/year. Within the study direct costs (medical costs: outpatient, inpatient, emergency, PAH-specific therapy, concomitant therapy; non-medical costs: pension due to disability status, payments for patients on sick-leave) and indirect costs (loss in GDP) were estimated. Results. Overall, 113 CTEPH patients (67 women and 46 men) from 33 Russian regions were included, mean age of patients with CTEPH was 54.6±13.95 years. Most of the patients (55%) were in able-bodied age. It was found that about half of patients with diagnosed CTEPH had a disability. Average duration of disease at the time of analysis was 6.88±11.41 years. Period from the first occurrence of symptoms to the confirmation of diagnosis of CTEPH was 2.58±5.21 years on average. More than 70% of patients had III and IV FC (WHO) at the time of diagnosis. Mean number of outpatient visits was 1.97±1.65 per patient/year, and inpatient visits were reported for 59% of patients. About 54% of patients used PAH-specific therapy, moreover 46% patients had interruptions of PAH-specific therapy (58.4±66.3 days). The total costs of CTEPH per patient/year were calculated as 805,901 RUB. The overall burden of CTEPH in Russia for total CTEPH population (470 patients) was 379 million RUB per year. Conclusions. CTEPH is the rare disease that is characterized with later diagnosis due to absence of disease-specific symptoms. Therefore economic burden of the CTEPH is significantly low in comparison to widespread cardiovascular diseases. Development of network of expert PH-centers and increase of the access for PAH-specific therapy will help to increase the quality of health care for patients with CTEPH.

Infrared Spectroscopy in Differential Diagnosis of Pulmonary Embolism

“…The development of chronic post-embolic pulmonary hypertension has been proved [ 12 – 14 ] to worsen not only patients quality of life but the disease prognosis as well, to require lifelong systemic therapy or operative intervention under extracorporeal circulation and hypothermia. Lethality and complications place a supplementary economic burden on the public health service and the state in general which, in particular, was clearly demonstrated in the recent investigations carried out in Russia and confirmed by the foreign authors [ 15 – 17 ].…”

2020 Clinical practice guidelines for Pulmonary hypertension, including chronic thromboembolic pulmonary hypertension

“…Хотя ХТЭЛГ и рассматривается в рамках венозной тромбоэмболии, предшествующие эпизоды ТЭЛА по данным Европейского регистра ХТЭЛГ удается подтвердить в 74,8% случаев, а тромбозы глубоких вен -в 56,1% случаев [33]. Учитывая жизнеугрожающий характер ХТЭЛГ, затраты на ведение одного пациента в Российской Федерации составляют 379 млн рублей, причем 91% из них -прямые затраты [34].…”

Chronic Thromboembolic Pulmonary Hypertension Mimicking Acute Pulmonary Embolism: A Case Report

“…Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare form of pulmonary hypertension (PH), with a reported prevalence in Latvia of 15.7 cases per million inhabitants [ 1 ]. Despite its low prevalence, CTEPH imposes a large burden both on patients and healthcare systems due to its complex management and high morbidity and mortality rates [ 2 , 3 ]. Although early diagnosis and treatment of CTEPH is crucial for the outcome of patients, CTEPH remains severely underdiag-nosed [ 2 , 4 , 5 ].…”