Pulmonary hypertension (PH) is a rare and life-threatening disorder marked by considerable morbidity and mortality. Off-label drug use is widespread because drugs have been approved only for the treatment of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Phosphodiesterase type 5 (PDE-5) inhibitors and endothelin receptor antagonists (ERAs) are most commonly prescribed as first-line treatment for PAH, and the more-efficacious prostacyclin therapies are used in later lines. Branded therapies dominate the PAH treatment algorithm, and combination therapy is common. Adempas is the only therapy approved for CTEPH. The lack of therapies approved for PH and the high morbidity and mortality associated with it make the disease a highly lucrative therapy market.


  • What is the current patient share in European countries of branded therapies such as United Therapeutics' Remodulin, Actelion’s Opsumit, and Bayer’s Adempas?
  • How long do patients typically take a particular medication before adding or switching PAH therapy?
  • In which PAH functional class is each drug class typically initiated?
  •  What are the anticipated changes in prescribing patterns over the next 12 months?
  • How are specialists using PAH therapies for the treatment of PH WHO Groups 2-5?
  • What are European specialists’ attitudes and perceptions regarding diagnosis and treatment of PH?
  • What are the drivers and constraints determining prescribing practices for PH?

Geographies: EU5: France, Germany, Italy, Spain, United Kingdom

Primary Research: Survey of 250 cardiologists / pulmonologists in the EU5

Key Drugs Covered: Uptravi, Opsumit, Remodulin, Adempas, sildenafil, tadalafil, iloprost, epoprostenol

Key Insights Provided

  • Factors influencing disease management and treatment decisions.
  • Drivers and constraints of treatment selection.
  • Physician-reported treatment practices and brand-level patient shares.
  • Rationale for changes in treatment approach.
  • Physician insight on persistency and compliance.
  • Physician-reported recent/anticipated changes in brand usage or treatment approach.

Table of contents

  • Pulmonary Hypertension - Current Treatment - Detailed, Expanded Analysis (EU5)

Author(s): David Rees, Ph.D

David Rees, M.Biochem., Ph.D, is a Business Insights Analyst with the Cardiovascular, Metabolic, and Renal Disorders team at Decision Resources Group. Prior to joining Decision Resources Group, Dr. Rees was a Postdoctoral Research Associate at Imperial College London, and the Institute of Cancer Research. For his doctoral research, he studied the structures of molecular machines in the Nobel Prize winning laboratory of Prof. Sir John Walker at the University of Cambridge. Dr. Rees earned his undergraduate M.Biochem. from the University of Bath.

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