Burden of hospitalization in relapsed acute lymphoblastic leukemia

Abstract

Objective: This study sought to quantify the economic burden of adults with Philadelphia chromosome negative (Ph-) relapsed B-precursor acute lymphoblastic leukemia (ALL) by examining hospitalization events in the US.

Research design and methods: The Truven Health MarketScan Commercial Database was used to identify eligible patients hospitalized between April 2009 and July 2014. Eligible patients were continuously enrolled 6 months before (pre-index) their first claim with an eligible relapsed ALL diagnosis (index date) and followed up for a maximum of 18 weeks.

Results: A total of 583 hospitalizations involving 205 adults with Ph(-) relapsed B-precursor ALL were identified. Mean (SD) percentage of follow-up time spent in the hospital was 56.2% (40.0%). Mean (SD) length of stay per hospitalization was 13.1 (15.7) days; mean (SD) reimbursement per hospitalization stay was $89,663 ($195,725). The highest reimbursements were hospitalization for ALL in relapse ($132,137 [$178,742]) and ALL without remission ($120,932 [$134,254]).

Conclusions: Adults with Ph(-) relapsed B-precursor ALL had repeated and prolonged hospitalizations during chemotherapy treatment associated with extremely high costs. More effective, tolerable treatments are needed.

Limitations: The key limitation was that the data source included only individuals from the health plans or the mid to large size employers in the MarketScan database. Patients who were not covered under these plans, or were only on Medicaid or only on Medicare, would not appear in our analysis.

Keywords: Acute lymphoblastic leukemia; burden of illness; chemotherapy; costs; healthcare resource utilization; hospitalizations.