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Introduction <p>To investigate the healthcare resource utilization (HCRU), medical costs in pulmonary arterial hypertension (PAH) patients in Japan, implementation of right heart catheterization (RHC), and treatment intensity, a retrospective observational cohort study using a nationwide health insurance claims database provided by JMDC Inc. was conducted.</p> Methods <p>Patients with PAH, classified based on evidence of a PAH diagnosis and PAH-targeted drug prescription within the same calendar month, were identified from the database. Demographic and clinical characteristics, as well as the implementation of RHC during the baseline period and the type of PAH-targeted drugs prescribed for the first-line therapy, were described. Outcomes included HCRU and direct medical costs between March 1, 2018 and March 31, 2023.</p> Results <p>A total of 405 patients with PAH were included in the analyses; 298 patients (73.6%) did not undergo RHC [RHC(−) cohort], and 107 patients (26.4%) underwent RHC [RHC(+) cohort] during the baseline period. Among the overall population, 59.3% received oral/inhaled monotherapy and 5.4% received parenteral prostacyclin analogue (PPA) combination therapy; 70.1% of the RHC(−) cohort received oral/inhaled monotherapy versus 29.0% in the RHC(+) cohort, 1.7% of the RHC(−) cohort received PPA combination therapy versus 15.9% in the RHC(+) cohort. Overall, the HCRU and the total medical costs tended to increase with treatment intensity in both RHC(−) and RHC(+) cohorts. The increase of the medical costs was mainly due to increase in costs related to hospitalization and prescription of PAH-targeted drugs.</p> Conclusion <p>The results revealed that HCRU and medical costs were especially high in those who were treated intensively with PPA combination therapy at first-line. In terms of extensive HCRU and associated medical costs, the limitations of existing treatment strategies for PAH were noted. In addition, these results highlight the need for innovative treatments to reduce the considerable disease burden described in this study.</p>

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Healthcare Resource Utilization and Medical Costs in Pulmonary Arterial Hypertension Management in Japan: A Retrospective Study Using a Claims Database

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月16日

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  • Atsushi Tajima,
  • Yoko Arai,
  • Takao Nakamura,
  • Shigeru Tokita,
  • Anna Watzker,
  • Takumi Sugiyama,
  • Noriaki Emoto

摘要

Introduction

To investigate the healthcare resource utilization (HCRU), medical costs in pulmonary arterial hypertension (PAH) patients in Japan, implementation of right heart catheterization (RHC), and treatment intensity, a retrospective observational cohort study using a nationwide health insurance claims database provided by JMDC Inc. was conducted.

Methods

Patients with PAH, classified based on evidence of a PAH diagnosis and PAH-targeted drug prescription within the same calendar month, were identified from the database. Demographic and clinical characteristics, as well as the implementation of RHC during the baseline period and the type of PAH-targeted drugs prescribed for the first-line therapy, were described. Outcomes included HCRU and direct medical costs between March 1, 2018 and March 31, 2023.

Results

A total of 405 patients with PAH were included in the analyses; 298 patients (73.6%) did not undergo RHC [RHC(−) cohort], and 107 patients (26.4%) underwent RHC [RHC(+) cohort] during the baseline period. Among the overall population, 59.3% received oral/inhaled monotherapy and 5.4% received parenteral prostacyclin analogue (PPA) combination therapy; 70.1% of the RHC(−) cohort received oral/inhaled monotherapy versus 29.0% in the RHC(+) cohort, 1.7% of the RHC(−) cohort received PPA combination therapy versus 15.9% in the RHC(+) cohort. Overall, the HCRU and the total medical costs tended to increase with treatment intensity in both RHC(−) and RHC(+) cohorts. The increase of the medical costs was mainly due to increase in costs related to hospitalization and prescription of PAH-targeted drugs.

Conclusion

The results revealed that HCRU and medical costs were especially high in those who were treated intensively with PPA combination therapy at first-line. In terms of extensive HCRU and associated medical costs, the limitations of existing treatment strategies for PAH were noted. In addition, these results highlight the need for innovative treatments to reduce the considerable disease burden described in this study.