Background: While multiple studies characterize healthcare resource utilization (HCRU) and costs of pulmonary arterial hypertension (PAH) overall, HCRU specific to end-of-life (EOL) is not well described.

Aim: To explore EOL-related HCRU and costs among patients with PAH.

Methods: This retrospective cohort study analyzed data of adult patients with PAH from the IQVIA PharMetrics® Plus (P+) database (OCT2014-MAR2022).  P+ does not include mortality data; therefore, evidence of fatality was determined by both a claims-based algorithm previously used in cardiovascular disease (Wade et al., 2020) and modified to PAH, and expert opinion. All-cause EOL-related HCRU and costs were explored within 30 days (30D) and 6 months (6M) of the assumed death date.

Results: Of 500 PAH patients identified, only 28 patients had evidence of EOL. The mean (SD) EOL-related costs were $48,846 (±$61,031; 30D) and $167,524 (±$150,223; 6M) per patient prior to their assumed death. Most patients had ?1 hospitalization during the EOL periods (17 [30D] and 23 [6M]), and hospitalizations contributed 58.8% (6M) to 70.8% (30D) of the EOL-related costs. Total pharmacy costs were the second leading driver of total costs, with a mean (SD) of $10,931 (±$15,903) and $52,466 (±$74,194) per patient during the 30D the 6M period, respectively (Figure).

Conclusion: PAH is associated with substantial EOL HCRU and costs, largely driven by hospitalizations.