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Financial Burden of Medical Therapy in Patients with Pulmonary Arterial Hypertension (PAH)

M Ghandour

Haytham Helmi

Charles Burger


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Conference: 2018 PHA International PH Conference & Scientific Sessions

Release Date: 06.28.2018

Presentation Type: Abstracts

File Download: Conference 2018_1045

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2018 International PH Conference and Scientific SeAbstract presented at the 2018 International PH Conference and Scientific Sessions in Orlando, Fla., June 28-July 1, 2018.

Background

Medical therapy for pulmonary arterial hypertension (PAH) is expensive and often has significant side effects. The purpose of this study is to assess the financial impact of PAH-specific therapy in the context of insurance drug coverage, out of pocket expenditures, utilization of supplemental assistance programs and compliance with therapy.

Methods

A prospective survey study between November 2017 and February 2018 was conducted enrolling 50 PAH patients followed in the PH Center at Mayo Clinic Florida and a descriptive data analysis was performed focused on income stratification, correlation with insurance plans, out-of-pocket-expenses, effects on treatment regimen choices and influence of aid from financial assistance programs..

Results

42 (84%) patients were women and 8 (16%) were men. The mean age at diagnosis and enrollment was 51 and 60 years, respectively. All patients were on PAH drug therapy: 13 (26%), 27(54%), 8 (16%) and 2(4%) on one, two, three and four-drug therapy, respectively. The majority, 38 (76%), had persistent PAH symptoms despite the medical therapy. In addition, 32 (64%) reported side effects from the PAH medications and 5(10%) patients emphasized that medication lowered their mood. Financially, 30(60%) of the patients had a current monthly out-of-pocket expenses with an average of approximately $1000. Furthermore, 28(54%) felt that the out-of-pocket expenses were financially burdensome. Notably, 17 (34%) required financial support from patient assistance programs, generally from non-profit organizations. Importantly, 6 (12%) of the patients missed their drug dosages at least once per month, perhaps to extend the prescription duration.

Conclusions

Most patients are symptomatic despite PAH-specific therapy. Furthermore, side effects are common. Most patients had health insurance that covered drug cost. Nonetheless, out-of-pocket expenses were significant. The survey results suggest that PAH has a substantial financial impact on patients that might affect their therapeutic compliance.