Loss of productivity among commercially insured patients with pulmonary arterial hypertension in the United States

Despite advances in treatment, pulmonary arterial hypertension (PAH) remains a progressive condition with the onset of disease often in working-aged adults, leading to substantial economic burden and increased healthcare resource utilization despite the rarity of the disease. The aim of this study was to estimate productivity loss for patients with PAH.
This was a retrospective cohort study of the Milliman Consolidated Health Cost Guidelines Source Data and the Merative MarketScan Commercial dataset between 01/01/2018 and 09/30/2023. Adult patients diagnosed and treated for PAH between 01/01/2019 and 08/31/2023 were identified and followed through the earliest of end of enrollment, or end of data. Outcomes were described as average workdays lost to receive healthcare services per-patient per-year (PPPY) and further assessed by healthcare setting. The cost of productivity loss was calculated based on the annual median household income.
The study included 1,588 commercially insured patients (mean age 52 years, 63% female). Between 2019–2023, the mean number of workdays lost ranged between 21 and 23 PPPY, equating to over 8% of annual workdays. The cost of loss of productivity ranged from $8,828 to $9,599 PPPY (in 2023 dollars). Across all study years, the largest proportion of workdays lost were attributed to emergency room (ER)/observation, followed by office visits, and outpatient facilities, altogether comprising two-thirds of total workdays lost. Inpatient hospitalization-related workday loss was approximately 11% of total workdays lost. Over the study period, the largest change in workdays lost was observed for ER/observation.
This study demonstrates substantial workdays lost due to health services utilization among patients with PAH, further adding to the overall economic burden of PAH. Quantifying productivity loss in PAH patients provides critical insight into the broader societal costs of the disease, supporting the inclusion of indirect costs in future economic evaluations and healthcare policy decisions.
Pulmonary arterial hypertension (PAH) is a rare but serious disease that often affects working-age adults. Even with advances in treatment, PAH continues to cause a substantial healthcare cost burden. This study looked at how much work people with PAH miss because of their medical needs.
Health insurance data from 2019 to 2023 was used to identify working-age adults with PAH and measure the number of workdays lost each year due to receiving healthcare. The cost of missed workdays was estimated using average household income.
On average, each person with PAH missed about 21 to 23 workdays per year, which is more than 8% of the total annual workdays. The value of this lost productivity ranged from $8,828 to $9,599 per person per year. Most missed workdays were due to emergency room visits, office visits, and outpatient care, while hospital stays accounted for about 11% of total workdays lost.
These findings show that people living with PAH lose a substantial amount of work time because of their condition, resulting in high indirect costs. Understanding this productivity loss is important for future decisions about healthcare policies and the economic impact of PAH.