Healthcare resource utilization and costs in patients with newly diagnosed acute myeloid leukemia

Abstract

Aim: Acute myeloid leukemia (AML) is associated with high disease burden. This analysis estimated HRU and costs among newly diagnosed AML patients in a US commercially insured population.

Materials and methods: This was a retrospective observational study using the IMS Health PharMetrics Plus and Hospital Charge Detail Master databases. Patients included adults who were newly diagnosed with AML between January 2007 and June 2016 (“study period”). Patients with <12 months of continuous enrollment prior to the index date were excluded, as were those whose first diagnosis was AML in remission/relapse, those diagnosed with acute promyelocytic leukemia, those on Medicare supplemental insurance, or those with a diagnosis of AML in remission/relapse without evidence of treatment during the study period. Patients were stratified by receipt of AML treatment (chemotherapy/hematopoietic cell transplantation [HCT]), and their follow-up was partitioned into initial, remission, and relapsed health states. Mean HRU and costs were tallied by treatment and, for treated patients, by health state and time since entry into health state (≤6 vs >6 months).

Results: A total of 9,455 patients met study criteria, including 6,415 (68%) treated and 3,040 (32%) untreated patients, with mean follow-up of 18.3 and 16.4 months, respectively. Mean age was 55 years in treated patients and 60 years in untreated patients. Mean total costs per patient were $386,077 in treated patients and $79,382 in untreated patients. For treated patients, 60% of total costs ($231,867 per patient) were incurred during the initial health state, representing time without remission/relapse. Mean monthly total healthcare costs were $21,055 and $4,854 among treated and untreated patients, respectively.

Limitations and conclusions: HRU and costs of managing AML patients are substantial. In treated patients, the majority of costs were incurred during the initial treatment period, without claims indicating remission/relapse.

Keywords:

• AML
• healthcare resource utilization
• costs
• newly diagnosed

JEL classification codes:

• I00
• I13

Note

Transparency

Declaration of funding

This study was sponsored by Jazz Pharmaceuticals, Inc.

Declaration of financial/other interests

MH, AS, and TED have received research funding from Jazz Pharmaceuticals, Inc. KCC was employed by Jazz Pharmaceuticals at the time of this research and is currently employed by Juno Therapeutics, Inc., a Celgene company, and has stock ownership in Amgen, Baxter, Bayer, Celgene, Gilead, Jazz Pharmaceuticals, and Shire. A peer reviewer on this manuscript discloses that they are employed by Pfizer, Inc.; the remaining peer reviewers have no conflicts of interest to disclose.

Acknowledgments

Editorial support was provided by Kimberly Brooks, PhD, CMPP of SciFluent Communications, and was financially supported by Jazz Pharmaceuticals, Inc.

Notes

a In the PharMetrics Plus database, there are patients covered by the Medicare Cost plan, also known as Medicare Gap or Medicare Supplemental. It is an insurance purchased by individuals to cover services not covered by traditional Medicare insurance. Patients submit claims to either Medicare or the Medicare Cost insurer depending on the services consumed. Only the data submitted to the Medicare Cost insurer are captured in the PharMetrics Plus database. Thus, patients on Medicare Supplemental plan lack complete healthcare information and were excluded from the study.