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

doi:10.1186/s12890-019-0989-1

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

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

45 Downloads (Pure)

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 language	English
Article number	226
Journal	BMC Pulmonary Medicine
Volume	19
Issue number	1
DOIs	https://doi.org/10.1186/s12890-019-0989-1
Publication status	Published - 27 Nov 2019
Externally published	Yes

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

Access to Document

10.1186/s12890-019-0989-1Licence: CC BY

Morrisroe_Economic_P2019Final published version, 541 KBLicence: CC BY

Cite this

@article{821ad8b5aed640b699a7d23d97f8cd36,

title = "The economic burden of systemic sclerosis related pulmonary arterial hypertension in Australia",

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.",

keywords = "Economic Burden, Healthcare utilization and associated direct cost, Pulmonary arterial hypertension, Scleroderma, Systemic sclerosis",

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

note = "{\textcopyright} 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.",

year = "2019",

month = nov,

day = "27",

doi = "10.1186/s12890-019-0989-1",

language = "English",

volume = "19",

journal = "BMC Pulmonary Medicine",

issn = "1471-2466",

publisher = "BioMed Central Ltd.",

number = "1",

}

TY - JOUR

T1 - The economic burden of systemic sclerosis related pulmonary arterial hypertension in Australia

AU - Morrisroe, Kathleen

AU - Stevens, Wendy

AU - Sahhar, Joanne

AU - Ngian, Gene-Siew

AU - Ferdowsi, Nava

AU - Hansen, Dylan

AU - Patel, Shreeya

AU - Hill, Catherine L.

AU - Roddy, Janet

AU - Walker, Jennifer

AU - Proudman, Susanna

AU - Nikpour, Mandana

N1 - © 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.

PY - 2019/11/27

Y1 - 2019/11/27

N2 - 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.

AB - 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.

KW - Economic Burden

KW - Healthcare utilization and associated direct cost

KW - Pulmonary arterial hypertension

KW - Scleroderma

KW - Systemic sclerosis

UR - http://www.scopus.com/inward/record.url?scp=85075746202&partnerID=8YFLogxK

U2 - 10.1186/s12890-019-0989-1

DO - 10.1186/s12890-019-0989-1

M3 - Article

C2 - 31775705

AN - SCOPUS:85075746202

SN - 1471-2466

VL - 19

JO - BMC Pulmonary Medicine

JF - BMC Pulmonary Medicine

IS - 1

M1 - 226

ER -

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

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Cite this