{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:07:36Z","timestamp":1787843256153,"version":"build-2784847793"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,4,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">To evaluate the cost\u2010effectiveness of combination pulmonary arterial hypertension specific therapy in systemic sclerosis\u2013related PAH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Health outcomes and costs were captured through data linkage. Health utility was derived from Medical Outcomes Study Short Form\u201036 scores. A probabilistic discrete\u2010time model was developed to simulate lifetime changes in costs and health utility. Mortality was predicted using a Gompertz parametric survival model. For both treatment arms, the simulations were started using the same cohort of 10\u00a0000 patients. Probabilistic sensitivity analysis was performed using the Monte Carlo simulation with 1000 sets of sampled parameter values. Of 143 patients with systemic sclerosis\u2013related pulmonary arterial hypertension, 89 were on monotherapy and 54 on combination therapy. Mean simulated costs per patient per year in monotherapy and combination therapy groups were AU$23\u00a0411 (US$16\u00a0080) and AU$29\u00a0129 (US$19\u00a0982), respectively. Mean life years and quality\u2010adjusted life years from pulmonary arterial hypertension diagnosis to death of patients receiving monotherapy were 7.1 and 3.0, respectively, and of those receiving combination therapy were 9.2 and 3.9, respectively. Incremental costs per life year and quality\u2010adjusted life year gained of combination therapy compared with monotherapy were AU$47\u00a0989 (US$32\u00a0920) and AU$113\u00a0823 (US$78\u00a0082), respectively. At a willingness\u2010to\u2010pay threshold of AU$102\u00a0000 (US$69\u00a0972) per life year gained, and of AU$177\u00a0222 (US$121\u00a0574) per quality\u2010adjusted life year gained, the probability of combination therapy being cost\u2010effective was 0.95.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The incremental cost per quality\u2010adjusted life year gained of combination therapy compared with monotherapy was substantial in the base case analysis. Given the fatal prognosis of systemic sclerosis\u2013related pulmonary arterial hypertension and the incremental cost per life year of AU$47\u00a0989 (US$32\u00a0920), combination therapy could be considered cost\u2010effective in systemic sclerosis\u2013related pulmonary arterial hypertension.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.015816","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T09:58:05Z","timestamp":1616579885000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Cost\u2010Effectiveness of Combination Therapy for Patients With Systemic Sclerosis\u2013Related Pulmonary Arterial Hypertension"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0224-2858","authenticated-orcid":false,"given":"An","family":"Tran\u2010Duy","sequence":"first","affiliation":[{"name":"Centre for Health PolicyMelbourne School of Population and Global HealthThe University of Melbourne Parkville VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Morrisroe","sequence":"additional","affiliation":[{"name":"Department of Medicine The University of Melbourne at St Vincent\u2019s Hospital (Melbourne) Fitzroy VIC Australia"},{"name":"Department of Rheumatology St Vincent\u2019s Hospital (Melbourne) Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Clarke","sequence":"additional","affiliation":[{"name":"Centre for Health PolicyMelbourne School of Population and Global HealthThe University of Melbourne Parkville VIC Australia"},{"name":"Health Economics Research Centre Nuffield Department of Population Health University of Oxford Headington United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Medicine The University of Melbourne at St Vincent\u2019s Hospital (Melbourne) Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3046-9884","authenticated-orcid":false,"given":"Susanna","family":"Proudman","sequence":"additional","affiliation":[{"name":"Rheumatology Unit Royal Adelaide Hospital North Terrace SA Australia"},{"name":"Discipline of Medicine University of Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Sahhar","sequence":"additional","affiliation":[{"name":"Department of Medicine Monash University Clayton VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandana","family":"Nikpour","sequence":"additional","affiliation":[{"name":"Department of Medicine The University of Melbourne at St Vincent\u2019s Hospital (Melbourne) Fitzroy VIC Australia"},{"name":"Department of Rheumatology St Vincent\u2019s Hospital (Melbourne) Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Australian Scleroderma Interest Group (ASIG)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2007.05.003"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.22910"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0517-5"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.40027"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1341-x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008503"},{"issue":"100","key":"e_1_3_2_8_2","first-page":"79","article-title":"Determinants of unemployment amongst Australian systemic sclerosis patients: results from a Multicentre Cohort Study","volume":"34","author":"Morrisroe K","year":"2016","unstructured":"Morrisroe K, Huq M, Stevens W, Rabusa C, Proudman SM, Nikpour M. 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