Global PAH Programme – Key results

Global PAH is a flexible, individual-level microsimulation model that projects future potentially avoidable hospitalisations and their wider clinical, health system, economic, societal and environmental impacts. Using nationally representative synthetic populations and country-specific data, the model projects how disease and hospitalisations may evolve over 2026–2035 and explores the potential impact of increasing uptake of guideline-directed medical therapy (GDMT) across five chronic conditions.

Table 1 Current uptake of GDMT by condition 2026 weighted average
Table 2 Projected primary-cause hospitalisations for leading and second leading conditions by 2035, with the percentage of hospitalisations potentially avoided with complete uptake of GDMT, and the combined share of primary-cause hospitalisations held by the two leading condtions Hospitalisation totals are cumulative
Table 3 Hospital capacity released under complete GDMT uptake by 2027 and 2035 Cumulative totals
Table 4 Costs potentially averted with complete uptake of GDMT by 2027 and 2035
Table 5Key outcomes and costs potentially avoided under different GDMT-uptake scenarios by 2027 and 2035

Current uptake of GDMT by condition 2026 weighted average

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Condition	Current GDMT uptake
Heart failure	21.0%
COPD	25.4%
Asthma	35.8%
Type 2 diabetes	34.8%
Hypertension^*	37.4%

^*Hypertension defined as control status.

Projected primary-cause hospitalisations for leading and second leading conditions by 2035, with the percentage of hospitalisations potentially avoided with complete uptake of GDMT, and the combined share of primary-cause hospitalisations held by the two leading condtions Hospitalisation totals are cumulative

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Country	Leading cause of potentially avoidable hospitalisations			Second leading cause of potentially avoidable hospitalisations			Combined share of the two leading conditions
Country	Condition	Projected to 2035	% avoided	Condition	Projected to 2035	% avoided	Top two as % of all
France	HF	2.0 million	35.0%	COPD	1.0 million	18.3%	71.80%
Italy	HF	1.9 million	37.6%	COPD	0.91 million	18.6%	85.30%
Netherlands	HF	0.39 million	35.0%	COPD	0.29 million	17.9%	85.70%
Spain	HF	1.6 million	33.8%	COPD	1.2 million	17.2%	84.70%
Japan	HF	3.1 million	31.8%	T2D	1.0 million	18.4%	81.30%
United States	HF	13.8 million	44.8%	T2D	8.1 million	15.8%	82.20%

Hospital capacity released under complete GDMT uptake by 2027 and 2035 Cumulative totals

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Country	Bed days avoided		Nursing days released		ICU bed days avoided		ED visits avoided
Country	2027	2035	2027	2035	2027	2035	2027	2035
France	2.4 million	12.7 million	1.4 million	7.3 million	116,400	604,700	1.3 million	7.0 million
Italy	1.9 million	10.7 million	1.1 million	6.1 million	135,000	747,800	1.1 million	5.8 million
Netherlands	287,000	1.6 million	185,100	1.0 million	3,100	16,900	96,000	510,200
Spain	1.3 million	7.1 million	727,700	4.0 million	27,400	154,900	1.0 million	5.6 million
Japan	7.8 million	38.4 million	2.3 million	11.4 million	217,300	1.1 million	2.3 million	11.1 million
United States	8.4 million	44.2 million	4.3 million	22.5 million	1.6 million	8.6 million	22.2 million	121.1 million
Total	22.1 million	114.8 million	10.0 million	52.3 million	2.1 million	11.2 million	28.0 million	151.2 million

Costs potentially averted with complete uptake of GDMT by 2027 and 2035

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Country	Inpatient care costs averted		ICU costs averted		ED costs averted		Productivity protected
Country	2027	2035	2027	2035	2027	2035	2027	2035
France	US$1.5 billion	US$8.2 billion	US$310.2 million	US$1.6 billion	US$512.8 million	US$2.8 billion	US$88.5 million	US$491.1 million
Italy	US$917.8 million	US$5.2 billion	US$338.3 million	US$1.9 billion	US$354.4 million	US$1.9 billion	US$52.9 million	US$236.9 million
Netherlands	US$217.6 million	US$1.2 billion	US$10.0 million	US$54.3 million	US$29.2 million	US$155.0 million	US$34.9 million	US$180.7 million
Spain	US$1.0 billion	US$5.5 billion	US$67.7 million	US$382.9 million	US$335.4 million	US$1.8 billion	US$38.7 million	US$208.6 million
Japan	US$2.3 billion	US$11.3 billion	US$117.6 million	US$567.4 million	US$450.7 million	US$2.2 billion	US$94.3 million	US$464.0 million
United States	US$26.9 billion	US$139.6 billion	US$3.0 billion	US$15.5 billion	US$45.3 billion	US$244.6 billion	US$7.5 billion	US$34.6 billion
Total	US$32.8 billion	US$171.1 billion	US$3.8 billion	US$19.9 billion	US$47.0 billion	US$253.4 billion	US$7.8 billion	US$36.2 billion

Key outcomes and costs potentially avoided under different GDMT-uptake scenarios by 2027 and 2035

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Outcome avoided	Year	100% GDMT	80% GDMT	10-percentage-point absolute increase on current practice GDMT
Hospitalisations	2027	2.6 million	1.9 million	345,900
Hospitalisations	2035	14.0 million	10.2 million	1.8 million
ED visits	2027	28.0 million	19.6 million	3.0 million
ED visits	2035	151.2 million	106.5 million	16.1 million
ICU stays	2027	338,400	249,800	43,600
ICU stays	2035	1.8 million	1.3 million	229,800
Total costs	2027	US$91.4 billion	US$66.4 billion	US$9.9 billion
Total costs	2035	US$480.6 billion	US$349.5 billion	US$51.3 billion

GDMT	Guideline directed medical therapy
HF	Heart failure
COPD	Chronic obstructive pulmonary disease
T2D	Type 2 diabetes
ICU	Intensive care unit
ED	Emergency department

Global PAH Programme – Key results

Current uptake of GDMT by condition 2026 weighted average

Abbreviations