Evaluation of healthcare resource utilization and incremental economic burden of patients with chronic myeloid leukemia after disease progression to blast phase

Figures & data

Figure 1. Selection of study population. CML, Chronic myeloid leukemia; AML, Acute myeloid leukemia-like; ALL, Acute lymphoblastic leukemia-like.

Table 1. Demographics and clinical characteristics of study cohorts.

	With progression	Without progression	p-value
	(n = 587)	(n = 7,504)
Age (years)
Mean (SD)	58.6 (14.9)	58.4 (15.8)	.81
Median	60	58
Age group			.01
18–34 years	38 (6)	541 (7)
35–44 years	58 (10)	837 (11)
45–54 years	125 (21)	1,590 (21)
55–64 years	179 (30)	2,286 (30)
65–74 years	92 (16)	935 (12)
75–84 years	79 (13)	876 (12)
≥85 years	16 (3)	439 (6)
Gender, n (%)
Male	356 (61)	4,197 (56)	.03
US geographic region, n (%)			.43
South	198 (34)	2,784 (37)
North Central	171 (29)	1,999 (27)
West	111 (19)	1,302 (17)
Northeast	92 (16)	1,223 (16)
Health plan, n (%)			.85
PPO	349 (59)	4,308 (57)
Comprehensive	79 (13)	1,134 (15)
HMO	67 (11)	896 (12)
POS	39 (7)	468 (6)
CDHP	14 (2)	236 (3)
EPO	9 (2)	108 (1)
POS with Capitation	2 (0.3)	37 (0.5)
Charlson Comorbidity Index (CCI)
Mean (SD)	3.7 (2.1)	3.1 (1.7)	<.001
Median	3	2
CCI group			<.001
CCI = 1–2	215 (37)	3,900 (52)
CCI = 3–4	246 (42)	2,443 (33)
CCI ≥ 5	126 (21)	1,161 (15)
Index treatment,* n (%)
Allo-HSCT	177 (30)	NA
Auto-HSCT	4 (0.7)	NA
Unspecified HSCT	3 (0.5)	NA
Chemotherapy	407 (69)	NA
Duration of follow-up (months)
Mean (SD)	8.7 (3.8)	10.0 (3.8)	<.001
Median	11	12

* Treatment on index date. Patients may have had claims for HSCT and chemotherapy on the index date and, therefore, the data are not mutually exclusive. However, very few patients received both HSCT and chemotherapy at the index date. The HSCT procedure categories are also not mutually exclusive, and patients may have had claims for multiple types of HSCT procedures.

SD, Standard deviation; PPO, Preferred provider organization; POS, Point of service; HMO, Health maintenance organization; CDHP, Consumer driven health plan; EPO, Exclusive provider organization; CCI, Charlson Comorbidity Index; HSCT, hematopoietic stem cell transplant.

Figure 2. Total all-cause medical and outpatient prescription costs per patient year in the baseline period.

Figure 3. Total all-cause medical and outpatient prescription costs per patient year in the follow-up.

Table 2. All-cause healthcare resource utilization and associated costs per patient year of study cohorts during the follow-up.

Healthcare resource utilization and costs	With progression	Without progression	p-value
	(n = 587)	(n = 7,504)
Number of hospitalizations
Mean (SD)	1.7 (2.0)	0.3 (0.8)	<.001
Median	1	0
Total hospital length of stay (days)
Mean (SD)	25.5 (36.2)	1.7 (7.9)	<.001
Median	10	0
Total hospital costs
Mean (SD)	$175,798 ($427,866)	$8,222 ($45,428)	<.001
Median	$39,763	$0
Number of outpatient medical service claims
Mean (SD)	397.0 (383.4)	82.8 (104.3)	<.001
Median	287	56
Total outpatient medical service costs		<0.001
Mean (SD)	$95,193 ($125,323)	$12,393 ($36,014)
Median	$57,870	$4,688
Total medical costs
Mean (SD)	$270,991 ($460,957)	$20,615 ($64,019)	<.001
Median	$153,272	$5,203
Number of outpatient prescription (Rx) drug claims
Mean (SD)	36.0 (37.7)	21.7 (27.3)	<.001
Median	26	13
Outpatient prescription (Rx) drug costs
Mean (SD)	$16,252 ($24,079)	$33,850 ($41,699)	<.001
Median	$3,406	$7,454
Total healthcare costs (hospital + outpatient + Rx)
Mean (SD)	$287,243 ($463,962)	$54,465 ($75,088)	<.001
Median	$167,286	$34,290

SD, Standard deviation.

Figure 4. Adjusted comparison of total all-cause healthcare costs per patient year in the follow-up. GLM 1: Covariates were age, gender, US geographic region, health plan type, Charlson Comorbidity Index, and follow-up duration. GLM 2: Additionally included total healthcare costs per patient during the baseline period. GLM, Generalized linear model; CI, 95% confidence interval.