Pentikäinen Markku, Simonen Piia, Leskelä Pauliina, Harju Terttu, Jääskeläinen Pertti, Wennerström Christina, Bødker Nikolaj, Heikkilä Eija, Lahelma Mari, Leskelä Riikka-Leena, Puhakka Airi, Heliövaara Elina, Kahlos Katriina, Korhonen Pentti, Kyllönen Tiina, Majamaa-Voltti Kirsi, Turpeinen Anu, Tuunanen Helena, Vepsäläinen Ville, Vihinen Tapani
Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
University of Helsinki, Helsinki, Finland.
Int J Cardiol Heart Vasc. 2024 Oct 22;55:101534. doi: 10.1016/j.ijcha.2024.101534. eCollection 2024 Dec.
Given that pulmonary arterial hypertension (PAH) and chronic thromboembolic hypertension (CTEPH) are rare yet severe subtypes of pulmonary hypertension significantly impacting patients' lives, this study analyzed the total societal costs of these conditions in Finland.
PAH (n = 247) and CTEPH (n = 177) patients diagnosed between 2008 and 2019 were analyzed for primary and specialty outpatient visits, emergency visits, hospitalizations, home and institutional care, sick leaves, disability pensions, and drug costs for 5 years before and after diagnosis.
In PAH and CTEPH, annual specialty care number of outpatient visits increased from 3.8 and 3.3 (5 years before diagnosis) to 13.8 and 9.5 one-year post-diagnosis, then decreased to 9.2 and 4.0 at 5 years post-diagnosis. Annual inpatient days rose from 2.8 and 2.7 to 16.1 and 19.7 pre-diagnosis, then fell to 10.2 and 3.5 post-diagnosis, respectively. Within 5 years post-diagnosis, in working-age 70 % PAH and 42 % CTEPH patients received disability pensions. Drug therapy accounted for most costs (67 % in PAH and 60 % in CTEPH), followed by inpatient care, disability pensions, and outpatient care. Total costs were significantly lower for CTEPH, especially after pulmonary endarterectomy. Among PAH subtypes, the highest costs were in patients with PAH associated with connective tissue diseases.
PAH and CTEPH cause a significant economic burden on patients and society with considerable differences depending on the PAH subtype and whether the patient has undergone PEA operation or not.
鉴于肺动脉高压（PAH）和慢性血栓栓塞性肺动脉高压（CTEPH）是肺动脉高压中罕见但严重的亚型，对患者生活有重大影响，本研究分析了芬兰这些疾病的社会总成本。
对2008年至2019年间确诊的PAH患者（n = 247）和CTEPH患者（n = 177）进行分析，统计诊断前后5年的初级和专科门诊就诊、急诊就诊、住院、家庭和机构护理、病假、残疾抚恤金以及药物费用。
在PAH和CTEPH患者中，专科门诊就诊的年次数从诊断前5年的3.8次和3.3次增加到诊断后1年的13.8次和9.5次，然后在诊断后5年降至9.2次和4.0次。年住院天数从诊断前的2.8天和2.7天增加到16.1天和19.7天，然后分别降至诊断后的10.2天和3.5天。在诊断后5年内，70%的PAH患者和42%的CTEPH患者在工作年龄时领取了残疾抚恤金。药物治疗占大部分费用（PAH中占67%，CTEPH中占60%），其次是住院护理、残疾抚恤金和门诊护理。CTEPH的总成本显著较低，尤其是在肺动脉内膜剥脱术后。在PAH亚型中，与结缔组织疾病相关的PAH患者费用最高。
PAH和CTEPH给患者和社会带来了重大经济负担，具体负担因PAH亚型以及患者是否接受了肺动脉内膜剥脱术而有很大差异。
