The economic burden of systemic sclerosis related pulmonary arterial hypertension in Australia

Abstract

BackgroundTo quantify the financial cost of pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc).MethodsHealthcare use was captured through data linkage, wherein clinical data for SSc patients enrolled in the Australian Scleroderma Cohort Study were linked with hospital, emergency department (ED) and ambulatory care databases (MBS) for the period 2008–2015. PAH was diagnosed on right heart catheter according to international criteria. Determinants of healthcare cost were estimated using logistic regression.ResultsTotal median (25th–75th) healthcare cost per patient (including hospital, ED and MBS cost but excluding medication cost) for our cohort during 2008–2015 was AUD$37,685 (18,144-78,811) with an annual per patient healthcare cost of AUD$7506 (5273-10,654). Total healthcare cost was higher for SSc-PAH patients compared with those without PAH with a total cost per patient of AUD$70,034 (37,222-110,814) vs AUD$34,325 (16,093 – 69,957), p < 0.001 respectively with an annual excess healthcare cost per PAH patient of AUD$2463 (1973-1885), p < 0.001. The cost of SSc-PAH occurs early post PAH diagnosis with 89.4% utilizing a healthcare service within the first 12 months post PAH diagnosis with an associated cost per patient of AUD$4125 (0–15,666). PAH severity was the main significant determinant of increased healthcare cost (OR 2.5, p = 0.03) in our PAH cohort.ConclusionsDespite SSc-PAH being a low prevalence disease, it is associated with significant healthcare resource utilization and associated economic burden, predominantly driven by the severity of PAH.

Economic burden of illness among patients with pulmonary arterial hypertension (PAH) associated with connective tissue disorders (CTD)

“…33 Similarly, an Australian study using data from 2008 to 2015 found that healthcare costs were almost twice as high among patients with SSc and PAH compared to those without PAH. 34 Our findings using more recent US data confirm the higher healthcare costs associated with CTD + PAH compared to CTD (without PAH), but also suggest a marked increase in the costs of CTD + PAH and CTD in the US with average annual all-cause total healthcare costs of $202,248 and $53,711, which is much more than expected from inflation.…”

“…In an earlier US study using data from 2003 to 2014, average annual all‐cause total healthcare costs in 2014 USD over the 5‐year follow‐up period postdiagnosis ranged from $44,454 to $63,320 among patients with SSc and PAH and from $18,513 to $23,269 among patients with SSc without PAH 33 . Similarly, an Australian study using data from 2008 to 2015 found that healthcare costs were almost twice as high among patients with SSc and PAH compared to those without PAH 34 . Our findings using more recent US data confirm the higher healthcare costs associated with CTD + PAH compared to CTD (without PAH), but also suggest a marked increase in the costs of CTD + PAH and CTD in the US with average annual all‐cause total healthcare costs of $202,248 and $53,711, which is much more than expected from inflation.…”

Pulmonary arterial hypertension in systemic sclerosis: a national inpatient analysis

“…These findings agree with a prospective multicenter study using the Australian Scleroderma Cohort Study (ASCS) database with a sample size of 5,527 SSc patients between 2008-2015 demonstrating higher hospital charges for these individuals. 17 The median THC in SSc-PAH was also significantly higher in a retrospective U.S. study during a 5-year follow-up period with a total cohort of 1,957 SSc patients with lung involvement. 18 It is important to understand the economic impact of PAH on the healthcare system to accelerate our efforts on prompt and aggressive man-…”

Effects of non‐pharmacological therapies on hand function and the ability to perform daily activities in people with systemic sclerosis: A systematic review and meta‐analysis of randomized control trials

“…As there is no cure for SSc and few effective disease‐modifying agents, SSc is linked to significant morbidity and mortality and reduced health‐related quality of life. Furthermore, SSc is associated with a large healthcare cost, with a high annual health service utilization cost per individual 13,14 …”

“…Furthermore, SSc is associated with a large healthcare cost, with a high annual health service utilization cost per individual. 13,14 The consequences of SSc on activities of daily living change with disease state and time. 2,15 Individual descriptions of living with the disease range from bothersome to impossible to live with.…”