Economic burden of elderly patients with acute myeloid leukemia treated in routine clinical care in the United States

Abstract

This retrospective claims database study examined healthcare utilization (HCU) and costs associated with acute myeloid leukemia (AML) in 237 elderly patients who received chemotherapy or a stem cell transplant (SCT) following AML diagnosis. Patients with secondary AML were excluded. Over the entire follow-up period, 92.0% of patients had ≥1 inpatient admission; 85.7% had ≥1 AML-related admission, and 42.6% had ≥1 non-AML-related admission. During inpatient admissions, 39.2% of patients had ≥1 intensive care unit (ICU) admission, with 20.7% having ≥1 AML-related ICU admission, and 27.8% having ≥1 non-AML-related ICU admission. Total mean per-patient per-month (PPPM) costs over the follow-up period were $25,243 (SD: $21,909), with costs from Year 1 ($27,756 [SD: $22,121]) more than double those in Year 2 ($12,953 [SD: $26,334]) following AML diagnosis. The majority of total costs were medical ($24,512 PPPM [SD: $21,704]), which included inpatient admissions ($6548 PPPM [SD: $10,777]), other outpatient visits ($5021 PPPM [SD: $7997]), supportive care ($3640 PPPM [SD: $5589], and chemotherapy administration ($2029 PPPM [SD: $2345]). Healthcare costs of treated elderly AML patients are substantial, particularly in the first year following diagnosis. Further research is needed to understand factors contributing to high costs in various settings of care for elderly AML patients.

The Economic Burden of Acute Myeloid Leukemia in Iran

“…In one study by Bella et al, the total direct medical cost of 237 patients with AML who received chemotherapy and transplant was 24512$. According to the results of this study, the portion of the direct medical cost of the economic burden is 19% and the portion of indirect cost is 65% which the part of the cost of productivity lost due to mortality was more than indirect costs [35].…”

“…Diagnosis of AML in patients with the high frequency of hospitalization, repetitive outpatient visits, and considerable use of expensive medications may result in higher costs for these patients [35,39]. Also, the progression of the disease and the increase in care increments the costs and need for intensive care and thus increase the cost of hospitalization in these patients.…”

Cost-analysis of Treatment of Patients with Acute Myeloid Leukemia

“…The diagnosis of AML in patients is associated with frequent hospitalizations, frequent outpatient visits, and significant use of expensive drugs that lead to higher costs for these patients (22,23). Also, the disease progression and the increase in patient care resulted in cost increases.…”

Catastrophic health expenditures of households living with pediatric leukemia in China

“…Leukemia requires repeated hospitalizations for treatment. 41 Hence, in terms of health services and treatment habits, 42,43 FCs preferred more specialized medical institutions to obtain better treatment for their loved ones with pediatric leukemia. Repeated hospitalizations require families, especially those living in rural areas, to bear more non-medical costs such as transportation and accommodation, which may not be covered by medical insurance.…”