Adjunct associate professor, Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT. Email:
Am J Manag Care. 2021 Mar;27(3 Suppl):S53-S58. doi: 10.37765/ajmc.2021.88611.
Pulmonary arterial hypertension (PAH) is a rare, progressive disorder associated with a poor prognosis if not treated appropriately. Fortunately, new treatment options have significantly improved survival rates and prognosis. Despite these advances, many patients do not receive the diagnosis until years into their disease or are inappropriately diagnosed. Early referral to specialized treatment centers that allows for early diagnosis and initiation of treatment significantly improves patient outcomes including survival as well as reduction in hospital admissions, which are a main driver of economic burden of disease. It is important that evidence-based guidelines are followed and treatment is individualized based on patient-specific factors. Pharmacologic therapies carry a very high cost for PAH; however, extensive utilization of management strategies may hinder access to medication and may lead to disease progression. Cost containment strategies may help to facilitate care coordination for earlier diagnosis and initiation of treatment, adherence to PAH medications, and patient education to ensure they are using medications appropriately to optimize therapy. Managed care pharmacists can play a crucial role in the multidisciplinary team in terms of medication safety, adherence, patient education, and follow-up to improve patient engagement that leads to improved outcomes.
肺动脉高压（PAH）是一种罕见的进行性疾病，如果得不到适当治疗，预后很差。幸运的是，新的治疗选择显著提高了生存率和预后。尽管取得了这些进展，但许多患者在疾病发生多年后才得到诊断，或者被误诊。早期转介到专门的治疗中心，以便进行早期诊断和开始治疗，可显著改善患者的预后，包括提高生存率以及减少住院次数，后者是疾病经济负担的主要驱动因素。重要的是要遵循循证指南，并根据患者的具体情况进行个体化治疗。肺动脉高压的药物治疗费用非常高；然而，广泛使用管理策略可能会阻碍药物的获取，并可能导致疾病进展。成本控制策略可能有助于促进医疗协调，以实现更早的诊断和治疗开始、肺动脉高压药物的依从性以及患者教育，以确保他们正确使用药物以优化治疗。管理式医疗药剂师可以在多学科团队中发挥至关重要的作用，包括药物安全、依从性、患者教育和随访，以提高患者的参与度，从而改善治疗效果。
