A MICROCOSTING STUDY OF CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION (CTEPH) BASED ON REAL WORLD DATA FROM BRAZIL
Author(s)
Ana Paula B S. Etges, PhD1, Milene Sehn, Msc2, Priscila Sperandio, MD3, Fernanda A. Donner, PhD4, Rodrigo Wainstein, PhD2, Marcelo Gazzana, PhD2, Eloara V M Ferreira, PhD3, Carisi A. Polanczyk, Ph.D4.
1Researcher, PEV Healthcare Consulting, Porto Alegre, Brazil, 2Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, 3Unifesp, São Paulo, Brazil, 4PEV Healthcare Consulting, Porto Alegre, Brazil.
1Researcher, PEV Healthcare Consulting, Porto Alegre, Brazil, 2Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, 3Unifesp, São Paulo, Brazil, 4PEV Healthcare Consulting, Porto Alegre, Brazil.
OBJECTIVES: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease that has pulmonary endarterectomy (PEA) as the gold standard treatment, while ballon pulmonary angioplasty (BPA) and guanylate cyclase stimulator (riociguat) are recommended for patients who cannot undergo surgery or who relapse after PEA. Only mechanical therapies are listed by the Brazilian public healthcare system and only few selected centers across the country offer treatment. This microcosting study used realworld data to estimate current costs associated with the management of Brazilian patients, aiming to provide accurate data for health technology assessment processes.
METHODS: Retrospective analyses were conducted at two public hospitals, involving 109 patients with CTEPH; in one center, only patients undergoing BPA were selected (n=11). Total outpatient visits, right heart catheterizations, and pharmacological therapies related to CTEPH were collected during follow-up. The amounts were individually collected and translated into costs using previous micro-costing data. Costs of mechanical treatments and hospitalizations were not included. Medication costs considered the Public Health Price Bank (PBS), all values are adjusted to 2024 and presented in Brazilian currency, Reais (R$).
RESULTS: The average follow up time at each center was 5.3 and 8.3 years, respectively. Of the 98 patients in one center, 36% underwent PEA, 18% used riociguat, and 59% off label therapies. Among the 11 patients who underwent BPA, 63% used riociguat and 82% other therapies. The average annual cost was R$73,693 (SD100,287) and R$166,793 (SD112,315), respectively, in patients with and without BPA. The average yearly cost for patients using riociguat was R$265,196 (SD45,726), and R$28,889 (SD31,832) for those not using riociguat. Among patients using only off-label therapies (sildenafil, bosentan, iloprost, ambrisentan), the average annual cost was R$41,650 (SD26,861).
CONCLUSIONS: Patients with CTEPH account for an excessive burden on the system. Strategies to reduce the impact of the disease should be pursued from both clinical and financial perspectives.
METHODS: Retrospective analyses were conducted at two public hospitals, involving 109 patients with CTEPH; in one center, only patients undergoing BPA were selected (n=11). Total outpatient visits, right heart catheterizations, and pharmacological therapies related to CTEPH were collected during follow-up. The amounts were individually collected and translated into costs using previous micro-costing data. Costs of mechanical treatments and hospitalizations were not included. Medication costs considered the Public Health Price Bank (PBS), all values are adjusted to 2024 and presented in Brazilian currency, Reais (R$).
RESULTS: The average follow up time at each center was 5.3 and 8.3 years, respectively. Of the 98 patients in one center, 36% underwent PEA, 18% used riociguat, and 59% off label therapies. Among the 11 patients who underwent BPA, 63% used riociguat and 82% other therapies. The average annual cost was R$73,693 (SD100,287) and R$166,793 (SD112,315), respectively, in patients with and without BPA. The average yearly cost for patients using riociguat was R$265,196 (SD45,726), and R$28,889 (SD31,832) for those not using riociguat. Among patients using only off-label therapies (sildenafil, bosentan, iloprost, ambrisentan), the average annual cost was R$41,650 (SD26,861).
CONCLUSIONS: Patients with CTEPH account for an excessive burden on the system. Strategies to reduce the impact of the disease should be pursued from both clinical and financial perspectives.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE284
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)