Economic and Clinical Burden of Acute Myeloid Leukemia Episodes of Care in the United States: A Retrospective Analysis of a Commercial Payer Database

Pandya, Bhavik J.; Chen, Chi‐Chang; Medeiros, Bruno C.; McGuiness, Catherine Balderston; Wilson, Samuel; Walsh, Elise Horvath; Wade, Rolin L.

doi:10.18553/jmcp.2020.19220

Cited by 17 publications

(17 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 In addition, AML is associated with an important clinical and economic burden to patients, their caregivers, and the healthcare system. 6,7 This disease is associated with different non-specific clinical manifestations, such as fatigue, dyspnoea, anorexia, fever, weight loss, infections, and bleeding, which are present at diagnosis of AML and during all treatments. 8,9 Therefore, a proper diagnosis is clinically important in determining the appropriate therapeutic strategy for patients with AML.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Gemtuzumab Ozogamicin for First-Line Treatment of Patients with Cd-33 Positive Acute Myeloid Leukaemia in Spain

Mareque¹,

Montesinos²,

Font³

et al. 2021

CEOR

View full text Add to dashboard Cite

Objective To assess the incremental cost–utility ratio (ICUR) of gemtuzumab ozogamicin (GO) + standard of care (SOC) vs SOC alone for treatment of patients with de novo AML from a Spanish Health Service perspective. Methods A cohort state-transition model, with 12 health-states, was used to estimate the lifetime accumulated cost and benefits in terms of quality-adjusted-life-years (QALYs) in AML patients with favourable, intermediate, and unknown cytogenetic profiles. Patient profile was defined based on the ALFA-0701 trial. Therapeutic regimens were defined by 5 haematologists. SOC was assumed to be idarubicin and cytarabine, the combination most used in Spain. QALYs were estimated by applying utilities for the time spent by the cohort in each health-state and utility decrements associated with adverse events (AE). Total cost (€,2020) included drug-acquisition, hematologic stem-cell transplantation, disease management, AE management and end-of-life costs. Unit costs were derived from local databases. All parameters were validated by haematologist. Costs and outcomes were discounted (3%/year). Results Higher cost/patient (€177,618 vs €151,434) and greater QALYs (5,70 vs 4,62) were obtained with GO+SOC vs SOC. The ICUR was €24,203/QALY gained. Conclusion This simulation suggests that GO + SOC could be a cost-effective option for treatment of patients with de novo AML in first line.

show abstract

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Gemtuzumab Ozogamicin for First-Line Treatment of Patients with Cd-33 Positive Acute Myeloid Leukaemia in Spain

Mareque¹,

Montesinos²,

Font³

et al. 2021

CEOR

View full text Add to dashboard Cite

show abstract

“…The same might apply to care costs, which remain dominated by inpatient charges. 43 The shift to more outpatient care and potentially more community-based care that newer medications facilitate may ultimately offset at least part of their high costs.…”

Section: Volume-outcome Relationship In Amlmentioning

confidence: 99%

Practice patterns and outcomes for adults with acute myeloid leukemia receiving care in community vs academic settings

Halpern

Walter

2020

Hematology

View full text Add to dashboard Cite

Consistent with observations in other disease settings, retrospective studies have indicated that treatment outcomes for adults with acute myeloid leukemia (AML) are better in higher- vs lower-volume hospitals and academic vs nonacademic centers, with greatest benefits noted in acute promyelocytic leukemia. Younger age, more frequent receipt of chemotherapy and hematopoietic cell transplantation, and differences in comorbidities and socioeconomic factors may partially account for these differences. With new therapeutic options including oral small molecule inhibitors and parenteral drugs suitable for outpatient administration, there is increasing interest from patients and physicians in treating AML in the community setting and avoiding referral to academic centers. This may be particularly true for older adults, for whom treatment rates in the community have historically been low, and for those with comorbidities, because treatment benefits are estimated to be low, and thus travel to academic centers is perceived as especially burdensome. How the volume-outcome relationship is affected by the shift of the treatment landscape in AML over the last few years is unknown. Additionally, improvements in supportive care (transfusion support, broad-spectrum oral antimicrobials), resulting in gradually decreasing early death rates over time, and the growing focus on the impact of AML therapy on quality of life and treatment cost concerns further fuel the larger trend toward an increasing proportion of care delivered in the outpatient setting. Here, we examine whether the current shift of administering chemotherapy and supportive care to the outpatient setting can be translated to the community setting without compromising patient outcomes.

show abstract

“…The high costs associated with the treatment of AML and other high-grade hematologic malignancies have been widely documented. 7,[9][10][11][12] Our analyses suggest that EHD after intensive AML induction chemotherapy leads to substantial reductions in charges for postchemotherapy care compared with the standard approach of keeping patients in the hospital until recovery of peripheral blood counts.…”

Section: Discussionmentioning

confidence: 89%

Financial Implications of Early Hospital Discharge After AML-Like Induction Chemotherapy: A 4-Year Retrospective Analysis

Moore

Othus

Halpern

et al. 2021

Journal of the National Comprehensive Cancer Network

View full text Add to dashboard Cite

Background: Early hospital discharge (EHD) after intensive acute myeloid leukemia (AML) induction chemotherapy has become routine at the University of Washington/Seattle Cancer Care Alliance over the past several years. We assessed the financial implications of EHD over the first 4 years after its broad adoption for patients with AML and other high-grade myeloid neoplasms undergoing AML-like induction chemotherapy. Patients and Methods: We retrospectively compared charges between 189 patients with EHD who received all postinduction inpatient/outpatient care within our care system between August 2014 and July 2018 and 139 medically matched control patients who remained hospitalized for logistical reasons. Charges from the day of initial discharge (patients with EHD) or end of chemotherapy (control patients) until blood count recovery, additional chemotherapy or care transition, hospital discharge (for control patients only), an elapse of 42 days, or death were extracted from financial databases and separated into categories: facility/provider, emergency department, transfusions, laboratory, imaging, pharmacy, and miscellaneous. Results: Combined charges averaged $4,157/day (range, $905–$13,119/day) for patients with EHD versus $9,248/day (range, $4,363–$48,522/day) for control patients (P<.001). The EHD cohort had lower mean facility/provider, transfusion, laboratory, and pharmacy charges but not imaging or miscellaneous charges. During readmissions, there was no statistically significant difference in daily inpatient charges between the EHD and control cohorts. After multivariable adjustment, average charges were $3,837/day lower for patients with EHD (P<.001). Conclusions: Together with previous data from our center showing that EHD is safe and associated with reduced healthcare resource utilization, this study further supports this care approach for AML and other high-grade myeloid neoplasms if infrastructure is available to enable close outpatient follow-up.

show abstract

Economic and Clinical Burden of Acute Myeloid Leukemia Episodes of Care in the United States: A Retrospective Analysis of a Commercial Payer Database

Cited by 17 publications

References 11 publications

Cost-Effectiveness Analysis of Gemtuzumab Ozogamicin for First-Line Treatment of Patients with Cd-33 Positive Acute Myeloid Leukaemia in Spain

Cost-Effectiveness Analysis of Gemtuzumab Ozogamicin for First-Line Treatment of Patients with Cd-33 Positive Acute Myeloid Leukaemia in Spain

Practice patterns and outcomes for adults with acute myeloid leukemia receiving care in community vs academic settings

Financial Implications of Early Hospital Discharge After AML-Like Induction Chemotherapy: A 4-Year Retrospective Analysis

Contact Info

Product

Resources

About