Impact of Diagnosis Delay on Healthcare Resource Utilization (HCRU) among Patients with Pulmonary Arterial Hypertension (PAH)
Author(s)
Aditi Paul, MPharm, MBA1, Sudhanshu Chawla, B.Tech2, Amit Chakraborty, B.Tech.1, Vaishali Gulia, B.Tech.1, Shailaja Daral, MBA, MD1, Vikash Kumar Verma, MBA, PharmD1, Abhimanyu Roy, MBA1, Ina Kukreja, MBA, PT1, Abhinav Nayyar, MBBS, MBA1, Arunima Sachdev, MA1, Marissa Seligman, BS Pharma3, Rahul Goyal, BS Tech4, Louis Brooks Jr, MA5, Riddhi Kumar Markan, M.SC. Economics3.
1Optum, Gurgaon, India, 2Optum, Noida, India, 3Optum, Boston, MA, USA, 4Optum, Phoenix, AZ, USA, 5Optum, Bloomsbury, NJ, USA.
1Optum, Gurgaon, India, 2Optum, Noida, India, 3Optum, Boston, MA, USA, 4Optum, Phoenix, AZ, USA, 5Optum, Bloomsbury, NJ, USA.
Presentation Documents
OBJECTIVES: To understand the burden of delayed PAH diagnosis on healthcare resource utilization and costs.
METHODS: Optum® de-identified Market Clarity Dataset, which links medical, and pharmacy claims with EHR data was used for this analysis. Patients with newly diagnosed PAH from Jan 2020 to Dec 2022 with continuous enrollment 48 months pre and 18 months post-index were identified from the data. Patients having any one of the underlying conditions (Such as pulmonary embolism, cirrhosis of liver, chronic obstructive pulmonary disease (COPD), Interstitial lung disease (ILD), autoimmune diseases etc.) with PAH-related symptoms in the baseline period were included in the analysis. The diagnosis delay was defined as first PAH symptom onset to diagnosis of PAH and was categorized in mutually exclusive cohorts (delay <1 year, ≥1 year & ≤2 years, >2 year). All cause and disease specific HCRU and cost were assessed in the 18 months follow-up period and compared against each cohort.
RESULTS: Of 872 PAH patients 693 (79.4%) patients were above the age of 60, 512 (58.7%) were female, 655 (75.1%) were Whites and 619 (70.9%) patients had Medicare as their insurance provider. COPD (45.5%) was the most commonly occurring comorbidity followed by pulmonary embolism (23.8%) and ILD (11.0%). In terms of diagnosis delay, 47.9% had a diagnosis delay of <1 year, 25.5% had delay of ≥1 year but ≤2 years, 26.5% had delay >2 years. The longer delay was associated with higher healthcare resource utilization and average per patient cost (<1 year: $13,380, ≥1 year & ≤2 years: $15,519, >2 years: 19,391), inpatient and ICU utilization being the cost driver. Statistical analysis will be applied to determine the level of significance.
CONCLUSIONS: The increased healthcare resource utilization and cost was associated with PAH diagnosis delay, which highlights the need for increased awareness and early screening.
METHODS: Optum® de-identified Market Clarity Dataset, which links medical, and pharmacy claims with EHR data was used for this analysis. Patients with newly diagnosed PAH from Jan 2020 to Dec 2022 with continuous enrollment 48 months pre and 18 months post-index were identified from the data. Patients having any one of the underlying conditions (Such as pulmonary embolism, cirrhosis of liver, chronic obstructive pulmonary disease (COPD), Interstitial lung disease (ILD), autoimmune diseases etc.) with PAH-related symptoms in the baseline period were included in the analysis. The diagnosis delay was defined as first PAH symptom onset to diagnosis of PAH and was categorized in mutually exclusive cohorts (delay <1 year, ≥1 year & ≤2 years, >2 year). All cause and disease specific HCRU and cost were assessed in the 18 months follow-up period and compared against each cohort.
RESULTS: Of 872 PAH patients 693 (79.4%) patients were above the age of 60, 512 (58.7%) were female, 655 (75.1%) were Whites and 619 (70.9%) patients had Medicare as their insurance provider. COPD (45.5%) was the most commonly occurring comorbidity followed by pulmonary embolism (23.8%) and ILD (11.0%). In terms of diagnosis delay, 47.9% had a diagnosis delay of <1 year, 25.5% had delay of ≥1 year but ≤2 years, 26.5% had delay >2 years. The longer delay was associated with higher healthcare resource utilization and average per patient cost (<1 year: $13,380, ≥1 year & ≤2 years: $15,519, >2 years: 19,391), inpatient and ICU utilization being the cost driver. Statistical analysis will be applied to determine the level of significance.
CONCLUSIONS: The increased healthcare resource utilization and cost was associated with PAH diagnosis delay, which highlights the need for increased awareness and early screening.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE320
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)