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Article History

Received: 26 September 2025

Accepted: 24 November 2025

First Online: 18 December 2025

Declarations

:

: Belinda Rivera-Lebron and Alison Witkin received consulting fees from Johnson and Johnson Innovative Medicine. Carly J Paoli, Sumeet Panjabi, and Gabriela Gomez Rendon are (or were at the time the study was conducted) employees of Actelion Pharmaceuticals US, Inc, a Johnson and Johnson company. Mark Small, Mia Harvey and Daniel Graham are full-time employees of Adelphi Real World, an agency which received a subscription fee for data access and analysis. Josanna Rodriguez-Lopez received consulting fees from Johnson and Johnson Innovative Medicine, Merck group, Bayer AG, and United Therapeutics.

: The DSP was conducted in line with European Pharmaceutical Market Research Association guidelines [ ], as well as all other relevant guidelines, including: the Health Insurance Portability and Accountability Act [ ], Health Information Technology for Economic and Clinical Health Act [ ], and the Declaration of Helsinki of 1964 and its later amendments [ ]. In addition, ethical exemption was provided by the Pearl institutional review board (protocol number: 2023-0280). No personally identifiable information was collected, and all data were pseudonymized by assigning responses a code that allowed for matching between physician and patient responses. Patients provided informed consent in the PSC for use of their anonymized and aggregated data for research and publication in scientific journals. Data were collected such that patients and clinicians could not be identified directly.