REAL-WORLD TREATMENT PATTERNS AND HEALTHCARE RESOURCE UTILIZATION OF PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION IN THE BRAZILIAN PUBLIC HEALTHCARE: A DATABASE STUDY
Author(s)
Renato Watanabe de Oliveira, MSc, PharmD1, Cibele Suzuki, BSc Pharm2, Vinicius Zilmer, Post-graduated3, Camila Veronez4, Thais Berra4, Gustavo Matheus4, Lays Leonel, PhD5.
1Johnson & Johnson, São Paulo, Brazil, 2Johnson & Johnson, S. Paulo, Brazil, 3Johnson & Johnson, Sao Paulo, Brazil, 4Brazil, 5São Paulo, Brazil.
1Johnson & Johnson, São Paulo, Brazil, 2Johnson & Johnson, S. Paulo, Brazil, 3Johnson & Johnson, Sao Paulo, Brazil, 4Brazil, 5São Paulo, Brazil.
OBJECTIVES: To describe treatment patterns and healthcare resource utilization among patients with pulmonary arterial hypertension (PAH) in the Brazilian public healthcare system.
METHODS: Retrospective study using DATASUS administrative databases (SIH, SIA), covering ~75% of the Brazilian population. Adults (≥18 years) with ≥2 PAH-specific drug claims (ICD-10 I27.0/I27.8), ≥1 inpatient/outpatient claim, and ≥12 months of follow-up between January 2019 and December 2024 were included. Descriptive analyses assessed demographics, resource use, and treatment patterns. Rates were calculated as events per person-year.
RESULTS: A total of 1,117 patients were identified, predominantly women (75.3%), with mean age 48.1 years (SD: 17) and 1.6 comorbidities. Most patients were treated in São Paulo (42.3%), followed by Pernambuco (8.4%) and Rio Grande do Sul (7.3%). Median follow-up was 33.1 months. Annual PAH-related hospitalization rates ranged from 0.7-1.7%. Among hospitalized patients, the mean was 1.6 admissions/year (SD: 1.4) and 10.1 days of stay (SD: 7.5); 36% required ICU care (mean 15.5 days; SD: 6.5). Overall, 14% experienced PAH-related hospitalization (rate: 0.54; 95% CI: 0.53-0.55). Treatment patterns shifted over time: monotherapy decreased (60.8% to 39.8%), while dual (45.8% to 54.7%) and triple therapy increased (1.8% to 16.3%). Sildenafil was the most common monotherapy (61.2%). The most frequent dual regimens were sildenafil+ambrisentan (73.4%) and sildenafil+bosentan (31.7%). Triple therapy mainly added iloprost. After the August 2023 PCDT update, 13.2% of patients escalated from dual to triple therapy.
CONCLUSIONS: PAH imposes substantial healthcare burden, with high hospitalization and ICU use. Combination therapy use has increased, partly reflecting policy changes, highlighting opportunities to further optimize treatment.
METHODS: Retrospective study using DATASUS administrative databases (SIH, SIA), covering ~75% of the Brazilian population. Adults (≥18 years) with ≥2 PAH-specific drug claims (ICD-10 I27.0/I27.8), ≥1 inpatient/outpatient claim, and ≥12 months of follow-up between January 2019 and December 2024 were included. Descriptive analyses assessed demographics, resource use, and treatment patterns. Rates were calculated as events per person-year.
RESULTS: A total of 1,117 patients were identified, predominantly women (75.3%), with mean age 48.1 years (SD: 17) and 1.6 comorbidities. Most patients were treated in São Paulo (42.3%), followed by Pernambuco (8.4%) and Rio Grande do Sul (7.3%). Median follow-up was 33.1 months. Annual PAH-related hospitalization rates ranged from 0.7-1.7%. Among hospitalized patients, the mean was 1.6 admissions/year (SD: 1.4) and 10.1 days of stay (SD: 7.5); 36% required ICU care (mean 15.5 days; SD: 6.5). Overall, 14% experienced PAH-related hospitalization (rate: 0.54; 95% CI: 0.53-0.55). Treatment patterns shifted over time: monotherapy decreased (60.8% to 39.8%), while dual (45.8% to 54.7%) and triple therapy increased (1.8% to 16.3%). Sildenafil was the most common monotherapy (61.2%). The most frequent dual regimens were sildenafil+ambrisentan (73.4%) and sildenafil+bosentan (31.7%). Triple therapy mainly added iloprost. After the August 2023 PCDT update, 13.2% of patients escalated from dual to triple therapy.
CONCLUSIONS: PAH imposes substantial healthcare burden, with high hospitalization and ICU use. Combination therapy use has increased, partly reflecting policy changes, highlighting opportunities to further optimize treatment.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD179
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Rare & Orphan Diseases