Healthcare resource utilization and costs during first salvage therapy for relapsed or refractory acute myeloid leukemia in the United States

Abstract

Real-world US healthcare resource utilization (HRU) and costs during first salvage therapy for relapsed/refractory (R/R) acute myeloid leukemia (AML) are described using IBM MarketScan® data (1/1/2007–6/30/2020). Treatments included high- (HIC) and low-intensity chemotherapy (LIC) alone, and gilteritinib, other FLT3 tyrosine kinase inhibitors (TKIs), and venetoclax with or without chemotherapy. Patients were diagnosed with R/R AML at ≥18 years of age between 1/1/2017–12/31/2019. Patient monthly all-cause HRU and costs were analyzed using a fixed-effects model. Data from 399 patients were analyzed (HIC, n = 104; LIC, n = 133; gilteritinib, n = 14; other FLT3 TKIs, n = 68; venetoclax, n = 80). Inpatient HRU was generally highest with HIC, whereas outpatient HRU was generally highest with LIC and venetoclax. Total all-cause incremental monthly costs appeared to be highest with HIC ($171,982) and similar for LIC ($60,512), gilteritinib ($47,218), other FLT3 TKIs ($43,218), and venetoclax ($77,566). Results highlight HRU and cost differences for R/R AML during first salvage therapy.

Keywords:

• Chemotherapy
• acute myeloid leukemia
• relapsed/refractory AML
• healthcare economics
• gilteritinib
• tyrosine kinase inhibitors (midostaurin and sorafenib)

Acknowledgments

Medical writing/editorial support was provided by Sarah A Thompson, PharmD, from OPEN Health, Parsippany, NJ, and editorial support by Cheryl Casterline, MA, from Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ, and funded by the study sponsor.

Disclosure statement

L Muffly reports consultancy fees from Amgen Inc., CTI BioPharm Corp., Kite Pharma, Medexus Pharmaceuticals Inc., Astellas, and Pfizer Inc.; research funding/grants from Jasper Therapeutics, Adaptive Biotechnologies, Kite Pharma, and Bristol Myers Squibb; and honoraria for speaker engagements from Adaptive Biotechnologies and Pfizer Inc. C Young, D Nimke, Q Feng, and BJ Pandya are employees of Astellas Pharma, Inc.

Data availability statement

Researchers may request access to anonymized participant level data, trial level data and protocols from Astellas-sponsored clinical trials at www.clinicalstudydatarequest.com.

For the Astellas criteria on data sharing see: https://clinicalstudydatarequest.com/Study-Sponsors/Study-Sponsors-Astellas.aspx

Additional information

Funding

This study was funded by Astellas Pharma, Inc.