Opinion
Video
Utilizing Health Economic Outcomes in Clinical Practice
Panelists discuss how patient financial burden varies significantly by insurance type and often leads to treatment interruptions, while prior authorization barriers create administrative challenges that could be improved through better collaboration between medical and payer communities.
Future Therapeutic Directions and Disease Remission
The future vision for PAH treatment centers on achieving disease remission, either partial or complete, fundamentally changing the disease trajectory from fatal progression to manageable chronic condition. This paradigm shift requires therapies that work through reverse remodeling mechanisms rather than solely providing symptomatic improvement. Sotatercept represents the first approved therapy with potential reverse remodeling properties, with several other compounds in development targeting similar mechanisms.
Investigational therapies showing promise include seralutinib, bardoxolone, and other compounds that may contribute to the reverse remodeling approach. The concept involves bringing PAH to a stage where patients can achieve normal life expectancy and quality of life despite having the disease. This vision suggests that within ten years, fewer patients may require parenteral prostacyclin therapy or lung transplantation if effective reverse remodeling therapies become widely available.
Future treatment approaches will likely incorporate personalized medicine principles, allowing selection of optimal therapy based on individual patient biology rather than current trial-and-error approaches. The development of multiple reverse remodeling agents combined with better patient phenotyping may enable achievement of disease remission in the majority of PAH patients, fundamentally altering the prognosis and management of this previously fatal condition.
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