Healthcare resource utilization in myeloproliferative neoplasms: a population-based study from Ontario, Canada

Abstract

Health resource utilization (HRU) and associated factors of high cost are not well understood in myeloproliferative neoplasms (MPNs). In this population-based, retrospective matched-cohort study, we used administrative health databases of Ontario, Canada to measure treatment costs and HRU for patients with MPN from 2004 to 2016 and compared them to matched controls. In 7130 patients with MPN [essential thrombocythemia (ET) = 3481; polycythemia vera (PV) = 2618; myelofibrosis (MF) = 1031], the mean annualized treatment costs were $16,646 for ET (controls, $7070); $16,360 for PV (controls, $7293); and $25,863 for MF (controls, $7386). Out of the total costs, the largest expenditure was on acute hospital care (ET: 57%, PV: 57%, MF: 66%). Older age (≥65), male gender, patients not seen by a specialist, and greater comorbidity burden were independent predictors of higher costs (p < 0.05). In addition, history of venous thrombosis in patients with ET and PV was associated with significantly higher treatment costs (p < 0.05).

Keywords:

• Myeloproliferative disorders < neoplasia
• health resource utilization
• predictors of treatment costs
• population-based study

Author contributions

Dr Gupta had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Bankar, Gupta.

Acquisition, analysis, or interpretation of data: Bankar, Zhao, Iqbal, Coxford, Cheung, Mozessohn, Earle, Gupta.

Drafting of the manuscript: Bankar, Gupta.

Critical revision of the manuscript for important intellectual content: all authors.

Statistical analysis: Zhao, Iqbal, Coxford.

Obtained funding: Gupta

Administrative, technical, or material support: Bankar, Iqbal, Zhao, Coxford, Earle, Gupta.

Study supervision: Gupta, Earle.

Acknowledgments

Parts of this study are based on data and information compiled and provided by the MOHLTC, Cancer Care Ontario, and the Canadian Institute for Health Information. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. We thank IMS Brogan Inc. for use of their Drug Information Database. The ORGD database was obtained from Service Ontario.

Disclaimer

This study made use of deidentified data from the Institute for Clinical Evaluative Sciences (ICES) Data Repository, which is managed by the Institute for Clinical Evaluative Sciences with support from its funders and partners: Canada’s Strategy for Patient-Oriented Research (SPOR), the Ontario SPOR Support Unit, the Canadian Institutes of Health Research and the Government of Ontario. The opinions, results and conclusions reported are those of the authors. No endorsement by ICES or any of its funders or partners is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information. However, the analyses, conclusions, opinions, and statements expressed herein are those of the authors, and not necessarily those of CIHI.

Disclosure statement

VG received an honorarium, clinical trial funding through the institution and served on an advisory board of Novartis, Celgene, and Sierra Oncology.

Additional information

Funding

This study was supported by IC/ES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). This study was also supported by MPN program grant (VG) from the Elizabeth and Tony Comper Foundation and the Princess Margaret Cancer Center Foundation.