OBJECTIVE
To assess the use of health care resources and socioeconomic burden in patients with newly diagnosed pulmonary arterial hypertension before diagnosis and throughout 12-month treatment, as well as the impact of treatment on these indicators in real clinical practice.
MATERIAL AND METHODS
A retrospective-prospective observational study included patients with various forms of pulmonary arterial hypertension. The diagnosis was verified by right heart catheterization. The data were collected by interviewing patients and reviewing medical records at inclusion in the study and every 3 months later. Some patients (57.6%) were included in the study a few months after right heart catheterization, but not more than 12 months later. We analyzed direct and indirect costs. The total follow-up period for each patient was 1 year before diagnosis and 1 year later.
RESULTS
The study included 33 patients. The median of annual expenses per a patient with pulmonary arterial hypertension was 234.570.07 rubles before diagnosis and 1.501.175.08 rubles after diagnosis. The median of direct costs was 110.661/902.456 rubles, direct non-medical costs — 2.213/74.025 rubles, indirect costs — 80.477/52.972 rubles before and after verification of pulmonary arterial hypertension, respectively. Thus, verification of diagnosis was followed by significant increase in costs for pulmonary arterial hypertension due to specific therapy (p=0.11·10–4). At the same time, establishing the diagnosis of pulmonary arterial hypertension significantly decreased all direct costs, except for the cost of specific therapy, and expenses for hospital-stay (p=0.11·10–4). There were no significant differences in direct non-medical (p=0.53) and indirect costs after verification of diagnosis (p=0.31).
CONCLUSION
Early diagnosis and availability of specific therapy will improve the quality of care for patients with pulmonary arterial hypertension and incur reasonable government costs for the treatment of these patients. Despite higher expenses for specific therapy, its early initiation can improve quality of life and avoid additional costs for hospital-stay.