Analysis of the cost-effectiveness of early diagnosis and pharmacotherapy of pulmonary arterial hypertension

Abstract

Over the past decades, health policy makers have focused on early diagnosis to introduce targeted and innovative treatments. Early diagnosis of pulmonary arterial hypertension (PAH) is associated with improved long-term survival, so screening high-risk groups is a reasonable strategy to improve outcomes in PAH treatment. Today, screening is an important part of preventive medicine, with the goal of detecting disease at an early and pre-symptomatic stage. All healthcare systems have limited resources and face opportunity costs; this means that any investment in a screening tool will come at the expense of other healthcare services, to the detriment of those patients who would otherwise be treated. By recognizing opportunity costs, health systems can require that health interventions be both clinically and cost-effective to be considered for implementation. The objective of the paper –to conduct a cost-effectiveness analysis of early diagnosis and pharmacotherapy of pulmonary arterial hypertension. Our analysis of the cost-effectiveness of early diagnosis and pharmacotherapy of pulmonary arterial hypertension is based on a cost‒utility model that estimates patient survival, which is significantly improved by reducing the delay in diagnosis of PAH and indicates the prevention of premature death of undiagnosed patients. The analysis of input data was conducted using systematic review, documentary, informational and graphical research methods. The results of the study showed that the choice of the target population and the level of diagnostic coverage of this risk group is critical for the cost-effectiveness of the implementation of PAH diagnostic screening. A decrease in these indicators leads to a decrease in the maximum allowable cost of diagnostic screening, and thus to a decrease in its profitability in real medical practice. The introduction of new treatments and the corresponding increase in the utility of PAP detection have the most positive effect on the profitability of the PAP diagnostic screening program. This cost-effectiveness analysis is the first attempt to evaluate the economic value of reducing the delay in PAH diagnosis compared to its benefits to the health care system and society as a whole.