Pulmonary Arterial Hypertension Diagnosis Results in Lost Work Productivity

Patients with pulmonary arterial hypertension who have commercial insurance lose more than 8% of annual workdays to seek treatment and other healthcare services, according to a poster presented recently at the American Thoracic Society 2024 International Conference.

Pulmonary arterial hypertension is a rare, progressive and life-threatening disease in which blood vessels in the lungs narrow, causing strain on the heart. About 40,000 people in the United States are living with PAH. The five-year mortality rate is about 43%.

In this retrospective study, which was sponsored by Merck, researchers assessed claims data from adult patients treated between Jan. 1, 2019, and Nov. 30, 2020, for patients who have commercial insurance. Researchers used data from Milliman’s Consolidated Health Cost Guidelines Source Databased and IBM’s MarketScan.

Researchers, led by Anna Watzker, associate director, outcomes research at Merck, identified 1,174 commercially insured patients for analysis. In 2019, they identified a total of 19,525 lost workdays, or about 8.7% of all available workdays. In 2020, there were 14,738 lost workdays, or about 8.2% of total available days.

On average, patients had 18.2 lost days in 2019 and 18.5 lost days in 2020. Based on median household income, researchers valued this lost work time at $6,614 per patient in 2019 and $6,587 per patient in 2020.

“Pulmonary arterial hypertension (PAH) is associated with an overall significant economic societal burden,” researchers wrote. “Our data add to the growing evidence of indirect healthcare resource utilization from productivity loss, which should be considered in the overall PAH economic burden. The impact could be even higher when accounting for PAH-related sick leaves, effect on work productivity, and loss of employment.”

Researchers said that one of the limitations of the study was that it relied on claims data from Milliman and IBM. Analysis using different sources, payer markets, and time periods may produce different results, researchers said. In addition, this study estimated productivity loss only due healthcare visits and did not account for other reasons for missed work.

There hasn’t been a lot of recent research on the impact of pulmonary arterial hypertension on employment and work productivity. One study from 2014 found that productivity loss among workers with pulmonary arterial hypertension was 44% higher than employers who did not have the disease.

More recent research analyzed workplace productivity in PAH outside of the United States. One study, published online in February 2022 in Frontiers in Psychiatry, surveyed patients in Germany about education, employment, productivity and quality of life. Researchers found that employment and work productivity of patients is impaired.

Another study, published in October 2022 in the European Heart Journal, focused on PAH patients in Sweden. This study was a retrospective observational case-control study of patients in the Swedish PAH registry, and found pulmonary arterial hypertension resulted in a heavy economic burden, with medications, disability and sick leave as the main cost drivers. Ten-year mean sick leave days was five times higher for PAH patients compared with controls. This study also found that costs for hospitalizations and outpatient visits increased three prior to a diagnosis of PAH.