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Hospitalizations of Pulmonary Arterial Hypertension Patients Stabilized on Oral Sildenafil

J. Margoilis

D. McMorrow

B. Johnson

K. Hvidsten

S. Watt

Raymond Benza

Srinivas Murali


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Conference: 2009 PH Resource Network Symposium

Release Date: 09.24.2009

Presentation Type: Abstracts

Margolis J1, McMorrow D1, Johnson BH1, Hvidsten K2, Watt S2, Benza R3, Murali S3
1. Thomson Reuters, Healthcare & Science, Washington, DC, USA 
2. Pfizer Inc., New York, NY, USA 
3.  The Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, West Penn Allegheny Health System, Pittsburgh, PA, USA

BACKGROUNDThe goal of this research was to estimate the prevalence of commercially-insured and Medicare PAH patients stabilized on oral sildenafil and admitted to an inpatient hospital for reasons other than a worsening of their PAH in order to identify possible breaks in continuation of this life sustaining therapy.

METHODSThis retrospective cohort study used administrative claims data from US commerciallyinsured and Medicare patients to calculate the prevalence and duration of inpatient hospitalizations with a secondary diagnosis of PAH among PAH patients on sildenafil maintenance therapy. Admission rates for patients with secondary PAH diagnoses were examined using pooled hospital inpatient data from a large US hospital data source.

RESULTSIn the Commercial/Medicare segment of this study, 32.1 admissions per 100,000 received therapy specific for PAH within 90 days prior to admission and 3.1 admissions per 100,000 were likely to be for patients stable on oral sildenafil therapy and admitted for treatment not associated with their PAH. The average hospital length of stay was 5.9 ± 7.0 days, median 4 days. In the Hospital segment of this study, 10.1 admissions out of 100,000 used sildenafil at some time during an average stay of 9.8 ± 9.0 days for admissions with a secondary diagnosis of PAH and may have been unable to receive oral medications for at least one day for medical reasons.

CONCLUSIONSAlthough the number of inpatient admissions of PAH patients stable on oral sildenafil may be between 3.1 per 100,000 and 10.1 per 100,000, a portion of these patients may be unable to receive oral medications during their hospital stay and are therefore at risk of clinical worsening of PAH due to this therapeutic interruption.