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

Kathleen Morrisroe, Wendy Stevens, Joanne Sahhar, Gene-Siew Ngian, Nava Ferdowsi, Dylan Hansen, Shreeya Patel, Catherine L. Hill, Janet Roddy, Jennifer Walker, Susanna Proudman, Mandana Nikpour

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Abstract

Background: To quantify the financial cost of pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc). Methods: Healthcare 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. Results: Total 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. Conclusions: Despite 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.

Original languageEnglish
Article number226
JournalBMC Pulmonary Medicine
Volume19
Issue number1
DOIs
Publication statusPublished - 27 Nov 2019
Externally publishedYes

Bibliographical note

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Keywords

  • Economic Burden
  • Healthcare utilization and associated direct cost
  • Pulmonary arterial hypertension
  • Scleroderma
  • Systemic sclerosis

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    Morrisroe, K., Stevens, W., Sahhar, J., Ngian, G-S., Ferdowsi, N., Hansen, D., Patel, S., Hill, C. L., Roddy, J., Walker, J., Proudman, S., & Nikpour, M. (2019). The economic burden of systemic sclerosis related pulmonary arterial hypertension in Australia. BMC Pulmonary Medicine, 19(1), [226]. https://doi.org/10.1186/s12890-019-0989-1