The Economic Burden of Myocardial Infarction in Latin America

Abstract

Objectives: To estimate the direct cost components of pulmonary arterial hypertension (PAH) in a Turkish setting. MethOds: Delphi-technique was used. An expert-panel consisting of members from cardiology, pulmonology and cardiovascular surgery met to discuss the disease management processes in PAH. The global and local-literature and guidelines have been reviewed and local clinical practices questionnaires (separately for functional classes (FC)) have been completed. All costcomponents, including medications, surgical treatment, hospitalization, screening and outpatient follow-up procedures were reviewed. February-2016 local prices released by Ministry of Health and Social Security Institution in Turkey were used as references. February-2016 currency rate was used. Results: The total-costs, excluding disease-specific medications, of PAH/year for patients in FC-II, FC-III and FC-IV were calculated as 576€ , 1,005€ and 5,542€ , respectively. The corresponding costs of disease-specific medications were 8,864€ , 17,920€ and 17,920€ (panel experts noted that disease-specific drugs are given in similar combinations and doses in FC-III and FC-IV). Therefore, the total annual-costs of PAH in FC-II, FC-III and FC-IV were estimated as 9,440€ , 18,925€ and 23,462€ , respectively. Costs of other components per annum, used in calculating the total-cost in FC-II, FC-III and FC-IV were as follows: follow-up: 101€ , 199€ and 1,355€ ; medications for palliation: 116€ , 156€ and 1,867€ ; non-pharmacologic treatment: 126€ , 366€ and 366€ ; laboratory tests: 232€ , 283€ and 1,211€ , respectively. Cost of lung-transplantation was found as 742€ in FC-IV (percentage of FC-IV patients assumed to be transplanted "lung" and "heart-lung" is 2.5% and 0.1%, respectively and price of each operation is 28,550€ [28,550x2.5%+28,5 50x0.1%= 742€ ]). cOnclusiOns: The main driver of direct cost components in PAH is the cost of disease-specific drugs. The total direct cost components increase when the functional class of the patients progresses from FC-II to FC-IV. Consequently, improving diagnosis rate and ensuring to start appropriate treatment in early stages in PAH patients may help to decrease the costs of treatment.