Patients who develop post-transplant lymphoproliferative disease (PTLD) within 1-year following allogeneic hematopoietic stem cell transplant (aHSCT) experience high health resource utilization (HRU) and costs, according to a recent analysis (J Med Econ. 2020;1-9. doi:10.1080/13696998.2020.1793765).
This analysis, conducted by Crystal Watson, MS, Atara Biotherapeutics, Inc, San Francisco, California, and colleagues, aimed to evaluate HRU aimed costs associated with PTLD in patients who underwent aHSCT.
MarketScan Commercial and Medicare Supplemental database claims from July 1, 2010 to December 31, 2017 were analyzed. Eligible patients received aHSCT between January 1, 2011, and December 31, 2015, had ≥6 months of continuous enrollment before aHSCT, and had ≥1 claim for PTLD or ≥1 inpatient or ≥2 outpatient claims for a clinically relevant lymphoma within 1 year following aHSCT. The first claim of PTLD diagnosis is referred to as the PTLD index in this analysis.
Researchers assessed HRU and total paid amounts from the week before aHSCT through 1-day pre-PTLD index and monthly from PTLD index through 1-year post-PTLD index. In this analysis, HRU is reported as a mean (SD).
Overall, 92 patients were eligible and included in the analysis. From aHSCT to PTLD, 98.7% of patients were hospitalized, with 1.7 (1.2) hospitalizations per patient. The average length of stay was 25.3 (22.2) days per patient.
From aHSCT to PTLD, 98.9% of patients has outpatient services with 233.7 (261.1) services per patient and 91.3% of patients had a prescription fill with 32.9 26) prescriptions per patient. In the first month post-PTLD index, 51.2% of patients were hospitalized.
Mean paid amounts were $399,470 per patient (range $7542–$1.7M) from aHSCT to PTLD. Cumulative mean paid amounts 1-year post-PTLD were $429,043 per patient. The total cost per patient per month was approximately 7 times higher in patients who died from PTLD (n = 49; $232,591) than those who lived (n = 43; $33,677). Costs were mainly driven by hospitalizations.
“HRU and costs from HCT to PTLD were high and more than doubled within 1-year post-PTLD. PTLD patients who died had ∼7 times higher costs than those who lived, driven by hospitalizations,” concluded Ms Watson and colleagues, adding that effective treatments are needed to reduce the burden of PTLD.—Janelle Bradley
