Final Panelist Thoughts on the Management of Pulmonary Arterial Hypertension

EP: 1.Pathophysiology of Pulmonary Arterial Hypertension

EP: 2.Differential Diagnosis of Pulmonary Arterial Hypertension

EP: 3.Importance of Early Detection and Monitoring for Disease Progression

EP: 4.Risk Stratification and the Importance of Patient-Centered Care

EP: 5.Strengths and Limitations of Current Therapeutic Options

EP: 6.Overview of Different Therapies for Patients with Pulmonary Arterial Hypertension

EP: 7.Sotatercept for Patients with Pulmonary Arterial Hypertension

EP: 8. The Role of the Prostacyclin Pathway

EP: 9.Important Clinical Considerations for Pulmonary Arterial Hypertension

EP: 10.Economic Impact of Pulmonary Arterial Hypertension

EP: 11.Barriers to Care for Patients with Pulmonary Arterial Hypertension

EP: 12.Utilizing Health Economic Outcomes in Clinical Practice

EP: 13.Outlining the Need for Equitable Access to Care

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EP: 14.Final Panelist Thoughts on the Management of Pulmonary Arterial Hypertension

Cost-Effectiveness and Access Considerations

Sotatercept clinical trials demonstrated 75-85% reductions in clinical worsening events including death, hospitalization, transplantation need, and disease progression, representing substantial cost savings through avoidance of expensive healthcare utilization. Early institution of effective therapies may further reduce downstream costs while potentially decreasing need for advanced parenteral prostacyclin therapies, which carry enormous medication and administration costs beyond the drug price itself.

The ICER analysis of sotatercept, published over a year ago, noted concerns that have since been addressed by additional clinical evidence, particularly regarding effectiveness in advanced disease cases now supported by ZENITH trial results. The analysis concluded sotatercept provides small to substantial benefit with overall endorsement of appropriate clinical utilization. Economic modeling suggests early sotatercept use could result in patients living three times longer with hundreds fewer hospitalizations per thousand patient-days and reduced transplant needs.

Alternative payment models focusing on value-based care and patient outcomes rather than fee-for-service arrangements could better align economic incentives with optimal PAH management. These models would emphasize hard-dollar total cost of care offsets and improved outcomes compared to traditional therapies, potentially providing more equitable access to high-cost but effective treatments. Future economic evolution may include opportunities for therapy de-escalation once disease control is achieved, providing long-term cost savings while maintaining remission states.