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February 19, 2026Pulmonary Therapy0 citationsOpen Access

Healthcare Resource Utilization and Medical Costs in Pulmonary Arterial Hypertension Management in Japan: A Retrospective Study Using a Claims Database

ATAtsushi TajimaYAYoko AraiTNTakao Nakamura

Key Result

Healthcare resource utilization and medical costs increased with treatment intensity in Japanese PAH patients, with mean annual costs ranging from 2.3 million JPY (oral/inhaled monotherapy) to 21.8 million JPY (PPA combination therapy) among those undergoing right heart catheterization.

Key Points

  • To assess healthcare resource utilization and medical costs in managing pulmonary arterial hypertension (PAH) in Japan.
  • Conducted a retrospective analysis using a claims database
  • Focused on patients receiving first-line PPA combination therapy
  • Analyzed healthcare resource utilization and associated costs
  • Intensive treatment with PPA combination therapy resulted in significantly higher medical costs
  • Existing treatment strategies showed limitations regarding healthcare resource utilization
  • Results underscore the need for new treatment options to decrease the disease burden

Study Design

Type

Observational (n=405)

Multicenter

Yes

Structured PICO

How do healthcare resource utilization and medical costs vary by treatment intensity and diagnostic pathway in patients with pulmonary arterial hypertension?

P
Population
405 patients newly diagnosed with pulmonary arterial hypertension (PAH) in Japan, median age 49.0, 76.0% female. Stratified by whether they underwent right heart catheterization (RHC) during baseline (298 RHC-, 107 RHC+).
I
Intervention
PAH-targeted therapies categorized by treatment intensity: oral/inhaled monotherapy, oral/inhaled combination therapy, or parenteral prostacyclin analogue (PPA) combination therapy.
C
Comparator
Comparison across different treatment intensities (monotherapy vs. combination therapies) and diagnostic pathways (RHC- vs. RHC+).
O
Outcome
Healthcare resource utilization (HCRU) and direct medical costs per patient per year (PPPY) between March 1, 2018 and March 31, 2023.

In Japanese patients with PAH, healthcare resource utilization and medical costs are substantial and increase significantly with the intensity of PAH-targeted therapy, particularly with parenteral prostacyclin analogue combinations.

Limitations

  • RHC status not used as inclusion criterion; some patients could have had RHC before baseline period and be misclassified.
  • Severity proxy based on treatment intensity rather than direct clinical measures such as WHO functional class due to database limitations.
  • Descriptive analysis without hypothesis testing or adjustment for confounders.
  • Claims data may lack detailed clinical information and confirmation of PAH diagnosis by RHC.
  • Potential inclusion of patients treated at non-specialized centers or with non-PAH pulmonary hypertension.
  • RHC(-) cohort might include patients with no immediate need for RHC, other types of pulmonary hypertension, or those who refused invasive testing
  • Patients who underwent RHC before the baseline period might be misclassified as RHC(-)
  • Small sample size in certain subcohorts (e.g., n=5 for PPA combination in RHC(-) cohort)

Abstract

The results revealed that HCRU and medical costs were especially high in those who were treated intensively with PPA combination therapy at first-line. In terms of extensive HCRU and associated medical costs, the limitations of existing treatment strategies for PAH were noted. In addition, these results highlight the need for innovative treatments to reduce the considerable disease burden described in this study.

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Cite This Study

Tajima et al. (2026) conducted an observational in Adults in Japan diagnosed with pulmonary arterial hypertension (PAH) with PAH-targeted drug prescription, stratified by whether they underwent right heart catheterization (RHC) at baseline (n=405). PAH-targeted drug therapy with varying treatment intensity: oral/inhaled monotherapy, oral/inhaled combination therapy, and parenteral prostacyclin analogue (PPA) combination therapy vs. Comparison among treatment intensities and RHC status was evaluated on Healthcare resource utilization (HCRU) and direct medical costs during follow-up. Healthcare resource utilization and medical costs increased with treatment intensity in Japanese PAH patients, with mean annual costs ranging from 2.3 million JPY (oral/inhaled monotherapy) to 21.8 million JPY (PPA combination therapy) among those undergoing right heart catheterization.

synapsesocial.com/papers/6996a818ecb39a600b3ee7a5https://doi.org/10.1007/s41030-026-00343-4
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