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. 2019 Jun;3(2):237-245.
doi: 10.1007/s41669-018-0100-5.

Economic Burden of Patients Treated for Higher-Risk Myelodysplastic Syndromes (HR-MDS) in Routine Clinical Care in the United States

Jill A Bell  1 , Aaron Galaznik  2 , Marlo Blazer  3 , Huai-Che Shih  3 , Eileen Farrelly  3 , Augustina Ogbonnaya  3 , Michael Eaddy  3 , Robert J Fram  2 , Douglas V Faller  2
Affiliations

Economic Burden of Patients Treated for Higher-Risk Myelodysplastic Syndromes (HR-MDS) in Routine Clinical Care in the United States

Jill A Bell et al. Pharmacoecon Open. 2019 Jun.

Abstract

Background and objective: Significant clinical burden is associated with higher-risk myelodysplastic syndromes (HR-MDS); however, the economic burden has not been fully examined. We examined cost of care and healthcare utilization (HCU) in HR-MDS patients engaged in routine care in the United States (US).

Methods: Adult US patients diagnosed with HR-MDS from 1/1/2008 to 10/31/2015 were identified from the Optum database. Patients were followed until death, progression to acute myeloid leukemia (AML), end of enrollment, or end of study (12/31/2015). Myelodysplastic syndrome (MDS)-related costs/HCU (including medical/pharmacy claims with a primary diagnosis of MDS, MDS-related treatment, or supportive care) and non-MDS-related costs/HCU were evaluated. Costs were calculated as per-patient per-month (PPPM) costs adjusted to 2015 US dollars.

Results: Of the 209 HR-MDS patients included, median follow-up was 9.9 months (interquartile range 4.6-17.9), and 69.4% had at least one inpatient admission, 56.9% had at least one emergency department visit, and nearly all patients had at least one outpatient visit. Average PPPM costs over follow-up were $17,361; year 1 versus year 2 costs were higher ($17,337 vs $12,976) following HR-MDS diagnosis. The majority of costs were for MDS-related medical services ($10,327 PPPM). MDS-related medical PPPM costs decreased from $10,557 (year 1) to $6530 (year 2). The main drivers of MDS-related medical costs and the decrease in year 2 were chemotherapy and supportive care costs.

Conclusions: The economic burden of HR-MDS is considerable, particularly within the first year of diagnosis. Treatment/supportive care costs accounted for a significant portion of MDS-related costs. As HR-MDS treatment evolves, the economic impact and HCU need to be further investigated.

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Conflict of interest statement

AG, JB, DF, and RF are employees of Takeda. HS, EF, MB, AO, and ME are employees of Xcenda, which has received research funding from Takeda for the conduct of this study and for the preparation of this manuscript.

Figures

Fig. 1
Fig. 1
Sample attrition. aDue to exclusion of patients with capitated claims for the cost analysis, 149 patients of the 209 treated HR-MDS patients were available for cost of care analyses. 1LT first-line therapy, AML acute myeloid leukemia, HR-MDS higher-risk myelodysplastic syndrome, MDS myelodysplastic syndrome, SCT stem cell transplant
Fig. 2
Fig. 2
Year 1 and year 2 post-index total PPPM costs among treated HR-MDS patients. HR-MDS higher-risk myelodysplastic syndrome, MDS myelodysplastic syndrome, PPPM per patient per month
Fig. 3
Fig. 3
Year 1 and year 2 post-index MDS-related (a) and non-MDS-related (b) PPPM medical costs among treated HR-MDS patients. ED emergency department, HR-MDS higher-risk myelodysplastic syndrome, MDS myelodysplastic syndrome, PPPM per patient per month
See this image and copyright information in PMC

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