Patterns of treatment and costs associated with transfusion burden in patients with myelodysplastic syndromes

Abstract

Transfusion dependence (TD) among myelodysplastic syndromes (MDS) patients negatively impacts survival and health-related quality of life. We evaluated cost patterns of MDS care during TD and transfusion independence (TI). MDS patients were identified from a US claims database (2008–2013). TD was defined as ≥2 consecutive 8-week periods with ≥1 claim during each, and no interim 56-day period without transfusion; TI as 8 subsequent transfusion-free weeks; and transfusion frequency as the mean interval between transfusions during the TD period. 13,741 patients were included; 19% were TD and 70% had a mean interval between transfusions of ≤28 days. During a 2-year period, TD patients incurred a mean total cost of $17,815/patient-month; 53% higher for those with ≤28 days ($19,498) vs. >28 days ($12,717) between transfusions. Among patients who achieved TI, mean total cost was $7874/patient-month. For TD-MDS patients, cost increases are proportional to transfusion frequency and achieving TI yields economic benefits.

Keywords:

• Myelodysplastic syndromes
• transfusion dependence
• transfusion independence
• cost
• health-related quality of life

Acknowledgements

The authors received editorial and writing support from Daniel Gilmartin, PhD, and Rosie Morland, PhD, from Excerpta Medica, sponsored by Celgene Corporation. The participation of Dr. DeZern and Dr. Smith in this publication was part of a collaboration with Celgene that was conducted outside of their Johns Hopkins faculty appointments. All opinions expressed and implied in this publication are solely those of Dr. DeZern and Dr. Smith, and do not represent or reflect the views of the Johns Hopkins University or the Johns Hopkins Health System. All authors had full access to the data and are fully responsible for content and editorial decisions for this manuscript.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at http://dx.doi.org/10.1080/10428194.2017.1312372.

Additional information

Funding

This work was supported by Celgene Corporation, Summit, NJ, USA.