Healthcare burden and reimbursement of hospitalization during chemotherapy for adults with Ph-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia in France: a retrospective chart review

Figures & data

Figure 1. Study schema. The index date was the first time in the medical records the patient was diagnosed with ALL that was refractory or had relapsed according to the inclusion criteria (with a first remission duration ≤12 months, within 12 months of HSCT, or in second or greater salvage therapy). The chemotherapy period was the time from first hospital admission for chemotherapy to the earliest of last dose of chemotherapy +30 days, start of HSCT, after 105 days, death, or loss to follow-up. The HSCT period was the time from start of HSCT to earliest of relapse, death, or loss to follow-up.

Figure 2. Reasons for hospital admission during the chemotherapy period. Reasons with a frequency of ≥10% are presented. More than one reason is possible for each admission.

Table 1. Patient characteristics and treatment received during salvage.

	n = 33
Age at index date, years
Median (range)	54 (19–75)
Male, n (%)	20 (61)
Disease status at index date, n (%)
Relapsed with first remission ≤12 months	17 (52)
Relapsed after first salvage	5 (15)
Relapsed after HSCT	7 (21)
Refractory to primary induction or salvage therapy	4 (12)
Status at the end of follow-up, n (%)
Dead	29 (88)
Alive (lost to follow-up)*	4 (12)
Treatment received during salvage
Chemotherapy	32 (97)
HSCT	7 (21)

Table 2. Hospitalizations in patients with Ph-negative B-cell precursor R/R ALL.

	Chemotherapy period (n = 32 patients)	Index date to death excluding the HSCT period (n = 33 patients)	HSCT period only (n = 7 patients)
Time spent in the hospital
Mean (SD) duration of study period in days	87 (35)	—	—
Proportion of time spent in the hospital, % (95% CI)	46 (34–57)	—	—
Hospital admissions data
Number of hospital admissions
Inpatient	71	121	18
Day hospital stay	70	141	20
Outpatient visit	6	23	79
Mean (SD) length of stay in days per inpatient hospitalization	16.8 (14.8)	13.7 (13.5)	33.9 (38.0)
Patient data
Mean (SD) number of hospital admissions per patient
Inpatient	2.2 (1.5)	3.7 (3.1)	2.6 (2.2)
Day hospital stay	2.1 (3.3)	4.3 (6.3)	2.9 (6.3)
Outpatient visit	0.2 (0.5)	0.7 (1.8)	11.3 (24.3)

Table 3. Reimbursement in patients with Ph-negative B-cell precursor R/R ALL.

	Chemotherapy period (n = 32 patients)	Index date to death excluding the HSCT period (n = 33 patients)	HSCT period only (n = 7 patients)
Mean (SD) reimbursement in Euros per hospital admission*
Inpatient	31 067 (4850)	28 832 (8867)	43 672 (33 241)
Day hospital stay	674 (0)	674 (0)	674 (0)
Outpatient visit	394 (0)	394 (0)	394 (0)
Total reimbursement in Euros per patient**	68 344	108 873	118 672

* based on a weighted average of hospitalization reimbursement for ALL from the 2013 French PMSI database.

** calculated by multiplying the reimbursement per admission by mean number of admissions per patient for each type of hospitalization.