Examining Health Care Utilization, Clinical Burden of AML for Payers

The incidence rate of patients diagnosed with acute myeloid leukemia has been progressing consistently over the last decade in the United States, prompting researchers to conduct an impact analysis on health care resource utilization (HRU), clinical burden, and direct health care costs for commercial US payers.

According to the latest research, experts estimate that AML will affect 21,450 new patients and result in 10,920 deaths in 2019. Bhavik J Pandya, PharmD, health economics & outcomes research, oncology, Medical Affairs Americas, Astellas Pharma US, Northbrook, IL, and colleagues sought to compare real-world cost estimates for typical AML treatments in order to better understand its economic burden. High-intensity chemotherapy (HIC), low-intensity chemotherapy (LIC), hematopoietic stem cell transplantation (HSCT), and relapsed/refractory were included.

Using data from IQVIA’s Real-World Data Adjudicated Claims Database and the IQVIA Charge Detail Master Hospital Database, the researchers calculated HRU based on physician office visits, nonphysician office visits, emergency department visits, inpatient visits, and outpatient pharmacy utilization. All-cause health care costs measurement was based on total allowed costs and reported by physician office visits, nonphysician office visits, emergency department visits, inpatient visits, and outpatient pharmacy utilization, explained the researchers.

The total mean episode costs were found to be highest in relapsed/refractory patients at $439,104 (n=707). Mean costs for the 1000 patients treated with HSCT were $329,621), followed by HIC-induction (n=1542; $198,657), HIC-consolidation (n=591; $73,428), and LIC (n=628; $53,081).

For all of the cohorts, the highest costs were related to hospitalization—ranging from $308,978 for relapsed/refractory to $49,580 for LIC patients. The researchers note that intensive care unit admission costs were a major contributor.

“In patients with refractory/relapsed AML and HSCT,” explained Dr Pandya, “expenditures related to pharmacy utilization averaged $24,640 and $12,203, respectively, and expenditures related to physician office visits averaged $10,926 and $6,090, respectively; these expenditures were much lower across other episodes.”

When examining symptom and toxicity events, results show that cardiovascular events were the only category of event that was a significant predictor of higher cost across all episodes.Other symptom and toxicity events commonly associated with AML were associated with significantly increased costs, especially in refractory/relapsed episodes, noted the researchers. —Edan Stanley