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Systematic Review of the Economic Burden of Pulmonary Arterial Hypertension

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Abstract

Background

Pulmonary arterial hypertension (PAH), as a life-threatening disease with no efficient cure, may impose a tremendous economic burden on patients and healthcare systems. However, most existing studies have mainly emphasised epidemiology and medications, while large observational studies reporting on the economic burden are currently lacking.

Objectives

To review and evaluate evidence on the costs of PAH and the cost effectiveness of PAH treatments, and to summarise the corresponding cost drivers.

Methods

Systematic literature searches were conducted in English-language databases (PubMed, Web of Science, ScienceDirect) and Chinese-language databases (China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP) to identify studies (published from 2000 to 2014) assessing the costs of PAH or the cost effectiveness of PAH treatments. The search results were independently reviewed and extracted by two reviewers. Costs were converted into 2014 US dollars.

Results

Of 1959 citations identified in the initial search, 19 papers were finally included in this analysis: eight on the economic burden of PAH and 11 on economic evaluation of PAH treatments. The economic burden on patients with PAH was rather large, with direct healthcare costs per patient per month varying from $2476 to $11,875, but none of the studies reported indirect costs. Sildenafil was universally reported to be a cost-effective treatment, with lower costs and better efficacy than other medications. Medical costs were reported to be the key cost drivers.

Conclusion

The economic burden of patients with PAH is substantial, while the paucity of comprehensive country-specific evidence in this area and the lack of reports on indirect costs of PAH warrant researchers’ concern, especially in China.

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Acknowledgments

The authors thank Xiaofang Liu, Lin Gao, Xuemei Zhen and Yuhang Zeng (Zhejiang University School of Public Health, Hangzhou, China) for their help in collecting the data.

Author Contributions

Shuyan Gu and Hengjin Dong conceived and designed the study. Shuyan Gu and Huimei Hu carried out the database search and the literature selection, and extracted and interpreted the data. Shuyan Gu produced the first draft of the manuscript and reviewed and revised the manuscript. Huimei Hu reviewed and revised the manuscript. Hengjin Dong oversaw the development of the work, reviewed and revised the manuscript and provided guidance. All authors reviewed and approved the final manuscript. Shuyan Gu and Hengjin Dong are the guarantors of the study.

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  1. Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China

    Shuyan Gu, Huimei Hu & Hengjin Dong

  2. Department of Public Health, Zhejiang Medical College, Hangzhou, Zhejiang, China

    Huimei Hu

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  1. Shuyan Gu
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Gu, S., Hu, H. & Dong, H. Systematic Review of the Economic Burden of Pulmonary Arterial Hypertension. PharmacoEconomics 34, 533–550 (2016). https://doi.org/10.1007/s40273-015-0361-0

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