OBJECTIVES: Pulmonary arterial hypertension (PAH) is a rare disease, with prevalence of up to 52 cases per million and few treatment options. Novel therapies in PAH management represent an important advance in treatment, therefore, a rationale budget allocation in the incorporation of those novel technologies is essential. Real world studies are crucial to support decision-making process in healthcare and, in PAH, real-world studies are scarce in Brazil. Therefore, the objective of the present study is to describe treatment patterns and resource utilization among PAH patients treated in the Brazilian public healthcare system (SUS).

METHODS: We extracted data from DATASUS database of patients diagnosed with ICD-10 I27 treated from 2014-2017. After this extraction, we performed a record linkage of inpatient and outpatient settings, as previously described. Treatment regimens were then classified and, subsequently, treatment patterns and resource utilization data summarized using descriptive statistics.

RESULTS: We identified 12,852 patients treated with PAH in the period, with median age of 52 years and 65.3% being female patients. Regarding treatment strategies, 69.7% of therapies were used in monotherapy, while 30.3% in combination therapy. When evaluating treatments separately, sildenafil (58.1%), sildenafil + bosentan (24.6%), bosentan (9.5%) and ambrisentan + sildenafil (9.5%) were the most commonly used therapies. Among the included patients, only 16 were not hospitalized in the period and 7.2% had at least one ICU stay in the evaluated period.

CONCLUSIONS: In the Brazilian public healthcare system, the great majority of PAH patients use monotherapy strategy. Additionally, sildenafil was the most commonly use treatment in the evaluated period. An important part of PAH patients had at least one hospitalization in the period, representing an important clinical and economic burden.