PMID- 32179923
OWN - NLM
STAT- MEDLINE
DCOM- 20211028
LR  - 20220531
IS  - 2737-5935 (Electronic)
IS  - 0037-5675 (Print)
IS  - 0037-5675 (Linking)
VI  - 62
IP  - 4
DP  - 2021 Apr
TI  - Help-seeking patterns and funding strategies in patients with pulmonary arterial 
      hypertension on phosphodiesterase-5 inhibitors: an orphan disease with effective 
      but costly treatment.
PG  - 199-203
LID - 10.11622/smedj.2020026 [doi]
AB  - INTRODUCTION: Pulmonary arterial hypertension (PAH) is associated with high 
      medical and pharmaceutical costs. Phosphodiesterase type 5 (PDE5) inhibitors have 
      been found to be beneficial but costly. They are not subsidised in Singapore 
      except via the Medication Assistance Fund (MAF) Plus scheme. In this study, we 
      described the help-seeking behaviour of patients and funding strategies for 
      Singaporean patients on PDE5 inhibitors in our registry. METHODS: We 
      consecutively recruited all patients with PAH who presented to our pulmonary 
      hypertension specialty centre between 1 January 2003 and 29 December 2016. 
      Singaporean patients on PDE5 inhibitors were included. Data recorded and analysed 
      for this study included baseline demographics, whether the patients received MAF 
      Plus funding, percentage of funding, and any additional source of subsidies. 
      RESULTS: 114 (77.0%) of 148 patients in the registry were Singapore citizens on 
      PDE5 inhibitors. 75 (65.8%) of these 114 patients had been seen by a medical 
      social worker, of whom 16 were on MAF Plus funding. 14 of the remaining 59 
      patients were subsidised by MediFund, whereas the remainder were self-paying. 30 
      (26.3%) patients in total were on some form of subsidy, and 28 (24.6%) patients 
      were on combination therapy. Of this group, nine were receiving MAF Plus 
      subsidies. CONCLUSION: Fewer than expected patients were found to be receiving 
      drug subsidies for PAH. This was partly due to insufficient referrals and lack of 
      requests for financial assistance. Patients on combination therapy had greater 
      financial challenges. This study should spur us on to study funding gaps further 
      and address them.
CI  - Copyright: (c) Singapore Medical Association.
FAU - Lim, Yinghao
AU  - Lim Y
AD  - Department of Cardiology, National University Heart Centre Singapore, Singapore.
FAU - Maaroof, Siti Munawarah Bte
AU  - Maaroof SMB
AD  - Department of Medical Social Work, National University Hospital, Singapore.
FAU - Low, Ting Ting
AU  - Low TT
AD  - Department of Cardiology, National University Heart Centre Singapore, Singapore.
FAU - Kuntjoro, Ivandito
AU  - Kuntjoro I
AD  - Department of Cardiology, National University Heart Centre Singapore, Singapore.
FAU - Yip, James Wl
AU  - Yip JW
AD  - Department of Cardiology, National University Heart Centre Singapore, Singapore.
FAU - Tay, Edgar
AU  - Tay E
AD  - Department of Cardiology, National University Heart Centre Singapore, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20200317
PL  - India
TA  - Singapore Med J
JT  - Singapore medical journal
JID - 0404516
RN  - 0 (Phosphodiesterase 5 Inhibitors)
RN  - EC 3.1.4.35 (Cyclic Nucleotide Phosphodiesterases, Type 5)
SB  - IM
MH  - Cyclic Nucleotide Phosphodiesterases, Type 5
MH  - *Help-Seeking Behavior
MH  - Humans
MH  - Phosphodiesterase 5 Inhibitors/economics/therapeutic use
MH  - *Pulmonary Arterial Hypertension/drug therapy
MH  - Rare Diseases
PMC - PMC8801821
OTO - NOTNLM
OT  - Asia
OT  - healthcare financing
OT  - phosphodiesterase 5 inhibitors
OT  - pulmonary hypertension
EDAT- 2020/03/18 06:00
MHDA- 2021/10/29 06:00
PMCR- 2021/04/01
CRDT- 2020/03/18 06:00
PHST- 2020/03/18 06:00 [pubmed]
PHST- 2021/10/29 06:00 [medline]
PHST- 2020/03/18 06:00 [entrez]
PHST- 2021/04/01 00:00 [pmc-release]
AID - j62/4/199 [pii]
AID - SMJ-62-199 [pii]
AID - 10.11622/smedj.2020026 [doi]
PST - ppublish
SO  - Singapore Med J. 2021 Apr;62(4):199-203. doi: 10.11622/smedj.2020026. Epub 2020 
      Mar 17.