[Current status and evolution of targeted therapy for pulmonary arterial hypertension in China]

Pulmonary hypertension (PH), especially pulmonary arterial hypertension (PAH), is a complex and life-threatening disorder with poor prognosis. Over the past two decades, PAH-targeted therapy in China has evolved through three distinct stages. Before 2006, the field was characterized by the absence of targeted therapies, limited disease awareness, and significant delays in diagnosis. Patients relied primarily on conventional treatments, with a 5-year survival rate of only 20.8%. Between 2006 and 2020, the introduction of targeted drugs such as iloprost and bosentan significantly improved patient outcomes. However, high costs and limited accessibility remained major barriers, with only around 20% of patients receiving targeted therapy and combination therapy used infrequently. Since 2020, expanded insurance coverage and the availability of domestic generics have substantially improved access to treatment. As a result, targeted therapy use has increased to nearly 80%, the 1-year mortality rate has declined to below 10%, and the 5-year survival rate now exceeds 70%. Meanwhile, clinical research has expanded rapidly, and nationwide specialist networks have been established, bringing standards of care closer to international levels. Looking forward, further efforts are needed to strengthen disciplinary development, promote multidisciplinary collaboration, and accelerate drug innovation to improve outcomes for patients with PAH in China.