Healthcare Resource Utilization and Cost of Patients with Multiple Myeloma in Germany: A Retrospective Claims Data Analysis

Abstract

Objective This study aimed to analyze the healthcare resource use (HCRU) and associated costs of multiple myeloma (MM) using German claims data. Methods Anonymized claims data from one of the largest sickness funds in Germany were analyzed. Costs and HCRU were calculated from the perspective of the statutory health insurance. To analyze MM-associated incremental costs in a most recent calendar period for an overall MM population (31 March 2018-31 March 2019), a prevalent cohort of MM patients (continuously insured during 01 January 2010 until 31 March 2019 or death; two or more outpatient and/or one inpatient MM diagnoses [ICD-10: C90.0-] and alive on 31 March 2018) was compared with a control group (not diagnosed with MM) employing propensity-score matching. Additionally, to describe MM-associated HCRU and costs for treated patients per line of treatment (lot), a cohort of newly treated patients was considered (≥ 12 months' pre-index period without MM treatment). Therapy lines were determined based on observed days of medication supply, treatment switches, and treatment discontinuations. Results Overall, 2523 prevalent MM patients (52.0% female, mean age: 71.3 years) and 1673 newly treated MM patients (50.2% female, mean age: 73.0 years) met the selection criteria and were included in the analyses. After matching, a non-MM counterpart could be identified for 2474 prevalent out of 2523 MM patients. MM-associated incremental HCRU was characterized by an increased number of hospitalizations and a higher number of outpatient specialist visits (per patient-year [ppy] 0.48 additional hospitalizations and 3.80 additional specialist visits; p < 0.001), being also drivers of the associated total incremental add-on costs (15,381.09 € ppy, p < 0.001). Among newly treated patients, total direct costs ppy increased as patients received subsequent treatments (1st lot: 67,681,55 €; 4th lot+: 114,934.01 €), driven by outpatient MM prescriptions (1st lot: 28,692.32 €; 4th lot+: 62,980.72 €). Conclusion The economic burden of MM is driven by outpatient prescriptions, inpatient hospitalizations, and outpatient specialist visits. Treatment and overall costs increase substantially when patients move to later lines of treatment.

Evolution of Pharmacological Treatments and Associated Costs for Multiple Myeloma in the Public Healthcare System of Catalonia: A Retrospective Observational Study

“…There is a scarcity in the literature of similar analyses including data from the last three years, during which, several regimens with meaningful clinical and economic impacts have been added to the MM therapeutic armamentarium. However, available studies describing MM treatment costs in earlier periods also showed progressive yearly increases [17,20], and multiple studies assessing MM healthcare resource utilization found that medicines were a key cost driver in any line of treatment [18,19,21,[47][48][49][50]. The mean cost per patient in a healthcare resource utilization study conducted in France was EUR 61,500 [22], almost EUR 10,000 lower than the figure reported here (EUR 70,816).…”

Real‐world utilization and healthcare costs for multiple myeloma: A retrospective analysis of patients in Singapore

“…These guidelines predominantly advocate for proteasome inhibitor-based therapies, as they offer superior response rates and improved survival outcomes, alongside the use of thalidomide, melphalan, lenalidomide, and cyclophosphamide [14]. In comparison to cost estimates from other countries, the monthly cost per patient for therapy medications alone in Singapore is higher than those reported in China [15], The Netherlands [16], and Germany [17], but considerably lower than the costs in the United States [18,19], which are nearly double. Several factors contribute to these variations.…”

Optimising the management of patients with multiple myeloma in Spain: A measurement of the social return on investment

“…All of these aspects are the primary contributors to the socioeconomic burden of the disease (Ernst & Young, 2018). According to recent studies, MM is a disease that poses a large burden on the healthcare system, in terms of therapy costs and healthcare resource consumption (Ashcroft et al, 2018; Kocaata et al, 2022; Kolovos et al, 2019; Ouchveridze et al, 2022), and to the patient and society given its financial toxicity (labour productivity losses, informal care and out‐of‐pocket expenses) (Jackson et al, 2019; Ortega‐Ortega et al, 2018; Ouchveridze et al, 2022; Parker et al, 2022). Therefore, the improvement in the management of the symptoms associated with MM, as well as the greater control of the disease, will benefit the quality of life of the patients in addition to a more efficient use of healthcare resources.…”