Hospital Burden of Pulmonary Arterial Hypertension in France: A Real-World Study Using the French Hospitalization Database (PMSI)
Author(s)
Olivier Sitbon, MD, Ph.D1, Marc Humbert, MD, Ph.D2, JULIA BONASTRE, PhD3, Louis Chillotti, PharmD4, Stève Bénard, PharmD5, Charlotte Cancalon, Master6, Céline Hautin, PharmD7, Lauren Cagnan, PharmD8.
1Faculté de Médecine, Université Paris-Saclay, INSERM UMR_S999, Hôpital Bicêtre, Le Kremlin-Bicêtre, France, 2Faculté de Médecine, Université Paris-Saclay, INSERM UMR_S999, Hôpital Bicêtre, Le Kremlin Bicêtre, France, 3Bureau Biostatistique et Epidémiologie, Gustave roussy, VILLEJUIF, France, 4Cytel, Oullins, France, 5stève consultants, Oullins, France, 6st[è]ve consultants, LYON, France, 7MSD France, Puteaux, France, 8HEOR manager, MSD France, Puteaux Paris, France.
1Faculté de Médecine, Université Paris-Saclay, INSERM UMR_S999, Hôpital Bicêtre, Le Kremlin-Bicêtre, France, 2Faculté de Médecine, Université Paris-Saclay, INSERM UMR_S999, Hôpital Bicêtre, Le Kremlin Bicêtre, France, 3Bureau Biostatistique et Epidémiologie, Gustave roussy, VILLEJUIF, France, 4Cytel, Oullins, France, 5stève consultants, Oullins, France, 6st[è]ve consultants, LYON, France, 7MSD France, Puteaux, France, 8HEOR manager, MSD France, Puteaux Paris, France.
OBJECTIVES: Pulmonary arterial hypertension (PAH) - pulmonary hypertension (PH) group 1 in the PH classification - is a rare chronic pulmonary disease that leads to progressive right heart failure. Given the limited real-world data on PAH in France, this study aimed to assess hospital management and related costs in French PAH patients.
METHODS: This claims cohort study used data from the French national discharge database between 2016 and 2022. PAH was defined as ≥1 hospitalization with a PH diagnosis code (ICD-10 codes I270/I272) or ≥1 PAH drug reimbursement. Other causes of PH (PH groups 2 to 5) were excluded. Patients were followed from their first PAH marker (PAH drug reimbursed on top of stay fees, PH hospitalization, right heart catheterization) to the end of follow-up or death. Outcomes were the characteristics of PAH patients, hospital resource use (HRU - hospitalizations, emergency room (ER) visits, transplantations), and costs. HRU and costs were described for the first year of follow-up and annualized for the remaining follow-up period.
RESULTS: Between 2016 and 2022, 2,108 patients were newly identified with PAH. Median (IQR) age was 64.0 (53.0-72.0) years, with 39% of men. Median follow-up duration was 4.8 (2.4-6.9) years. During the first year post-inclusion, the mean (SD) number of PAH hospitalizations was 3.2 (2.0), decreasing to 1.3 (1.9) per year in the following years. Similarly, mean (SD) number ER visits was 1.5 (0.9) in the first year, and 0.5 (0.4) per year afterwards. Finally, mean (SD) hospitalization costs per patients were €15,978 (€26,105) and €7,563 (€10,287) for the same periods, respectively. Transplantation rate (95%CI) was 2.3 (1.3-3.7) per 1,000 person-year.
CONCLUSIONS: This study showed that the hospital burden of PAH was significant. HRU and costs were maximal during the first year of follow-up and progressively decreased afterwards. Transplantations remained rarely undergone.
METHODS: This claims cohort study used data from the French national discharge database between 2016 and 2022. PAH was defined as ≥1 hospitalization with a PH diagnosis code (ICD-10 codes I270/I272) or ≥1 PAH drug reimbursement. Other causes of PH (PH groups 2 to 5) were excluded. Patients were followed from their first PAH marker (PAH drug reimbursed on top of stay fees, PH hospitalization, right heart catheterization) to the end of follow-up or death. Outcomes were the characteristics of PAH patients, hospital resource use (HRU - hospitalizations, emergency room (ER) visits, transplantations), and costs. HRU and costs were described for the first year of follow-up and annualized for the remaining follow-up period.
RESULTS: Between 2016 and 2022, 2,108 patients were newly identified with PAH. Median (IQR) age was 64.0 (53.0-72.0) years, with 39% of men. Median follow-up duration was 4.8 (2.4-6.9) years. During the first year post-inclusion, the mean (SD) number of PAH hospitalizations was 3.2 (2.0), decreasing to 1.3 (1.9) per year in the following years. Similarly, mean (SD) number ER visits was 1.5 (0.9) in the first year, and 0.5 (0.4) per year afterwards. Finally, mean (SD) hospitalization costs per patients were €15,978 (€26,105) and €7,563 (€10,287) for the same periods, respectively. Transplantation rate (95%CI) was 2.3 (1.3-3.7) per 1,000 person-year.
CONCLUSIONS: This study showed that the hospital burden of PAH was significant. HRU and costs were maximal during the first year of follow-up and progressively decreased afterwards. Transplantations remained rarely undergone.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD98
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Rare & Orphan Diseases