Costs, Utilization Associated with Chronic Myeloid Leukemia

San Diego—A retrospective cohort analysis of medical claims databases found that the costs associated with treating patients with chronic myeloid leukemia (CML) were substantial, with the majority of the expenses attributed to hospitalizations. The results were presented at the ASH meeting in a poster titled Health Care Utilization and Cost in Patients with Chronic Myeloid Leukemia in a Privately Insured Patient Population in the United States. The study included 2583 patients who were identified from 2 sources: the Thomson Reuters MarketScan commercial claims and encounters database and the Medicare supplemental database. In all, the databases had medical and pharmacy claims from approximately 68 million beneficiaries. Patients were included if they had ≥2 medical claims related to CML between January 1, 2002, and December 31, 2009. The authors defined the index date as the date the patient was initially diagnosed with CML. Patients were required to have been enrolled in the database at least 6 months before initial CML diagnosis and for at least 12 months after the diagnosis. The authors examined resource utilization and costs during each patient’s enrollment and calculated them on a daily basis. The patients were followed for an average of 2.7 years. Approximately 55% of patients were males, >80% were ≥45 years of age, and approximately 38% were ≥65 years of age. In addition, >50% of patients were enrolled in point-of-service health plans with capitation coverage. Among the patients with ≥1 year of follow-up, 32% of patients had inpatient, CML-related visits; 95% had outpatient, CML-related visits; and 15% visited the emergency department (ED) for CML-related reasons. The mean number of outpatient, CML-related visits per patient-year was 7.1 compared with 4.8 CML-related office visits per patient-year. The patients also filled a mean of 6.7 prescriptions per patient-year for CML; CML drug costs accounted for 73% of prescription costs. Of the prescriptions filled for tyrosine kinase inhibitors, 85% were for imatinib. The mean annual healthcare costs were $64,441 per patient-year, including CML-related per patient-year costs of $23,166 per year. The mean annual per patient-year costs were $24,391 for outpatient visits, $24,462 for inpatient visits, and $15,588 for prescription drugs. Approximately 20% of patients were followed for ≥4 years and were included in a subanalysis. Among the patients followed for ≥4 years, 32% of patients had inpatient, CML-related visits; 98% had outpatient, CML-related visits; and 15% visited the ED for CML-related reasons. The mean number of CML-related outpatient visits per patient-year was 4.8 compared with 3.3 CML-related office visits. In the subanalysis, the mean annual healthcare costs were $40,682 per patient-year, including CML-related costs of $16,734 per patient-year. The mean outpatient visits costs were $14,203 per patient-year, the mean inpatient visits costs were $9890 per patient-year, and the mean ED visits costs were $348 per patient-year. The authors mentioned a few limitations. For instance, claims from Medicare and Medicare Part D may not have been included in the databases, which would lead to a lower estimate of healthcare utilization and costs. The analysis also did not include emerging therapies and recent drugs approved by the US Food and Drug Administration. Finally, the authors said other data could be missing because of the nature of a retrospective analysis. This study was sponsored by Pfizer, Inc.