Análisis de la evolución del tratamiento de hipertensión pulmonar

Resumen

Objetives: To analyze the evolution experienced in the pharmacologic treatment of pulmonary hypertension (PH) and to evaluate their economic impact. Method: Retrospective study of the treatment patterns of all patients assisted by the Pulmonary Hypertension Unit of our hospital from January, 2002 to April, 2004. Clinical records and outpatients registry of drug dispensation were reviewed. In order to evaluate the economic impact, the theoretical monthly cost associated with every treatment schedule and the average monthly cost per patient were calculated. Results: A total of 101 patients diagnosed with PH (40 men and 61 women) with an average age of 46 years (9-80 years) were studied. According to PH type, the distribution was the following: 34.7% of primary PH and 65.3% of secondary PH. Eleven treatment schedules were analyzed (5 monotherapies and 6 combination therapies). The treatments based on intravenous and subcutaneous prostacyclins have decreased. Contrarily, there has been an increase in the use of inhaled and oral prostacyclins. The average monthly costs per patient corresponding to the months March-April were 8,033.4 euros in 2002, 5,345.1 euros in 2003 and 5,460.1 euros in 2004. Conclusions: In the last few years, a significant change has occurred in the treatment of PH caused by the introduction of oral forms (bosentan and sildenafil) and the inhaled prostacyclin (iloprost) A decrease of intravenous (epoprostenol) and subcutaneous (treprostinil) prostacyclin was noted. Also it is observed an increase in the use of combination therapies, and a reduction in the average monthly cost per patient