Phm20 Value of Transfusion-Free Living in Mds: Results of Health Utility Interviews With MDS Patients

Goss, TF; Szende, Ágota; Schaefer, Carl F.; Knight, R; Heptinstall, Kathleen; Lübbert, Michael; Deschler, Barbara; Fenaux, Pierre; Mufti, G J; Killick, Sally; List, Alan F.

doi:10.1016/s1098-3015(10)65047-4

Cited by 2 publications

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“…Most MDS patients develop anemia which is treated with blood transfusions. Transfusion dependency leads to decreased quality of life [11] as well as life expectancy [12;13] and produces enormous cost to patients and the health care system [14;15]. Further, transfusion dependent patients with a good long term prognosis require iron chelation therapy for prophylaxis against secondary hemosiderosis [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Cost of transfusion-dependent myelodysplastic syndrome (MDS) from a German payer’s perspective

et al. 2010

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Background: No curative treatment exists for patients with myelodysplastic syndrome (MDS) besides allogeneic stem cell transplantation. Hence, palliative treatment is provided for a life time accruing high health care cost. As no cost study of MDS exists in Germany, the objective of this study was to assess and analyse costs of transfusion-dependent low/intermediate-1 risk MDS in Germany from a payers' perspective. Patients and methods: 116 low/intermediate-1 risk transfusion-dependent MDS patients with and without isolated 5q-deletion from seven centers were identified. Claims data and patient records of the previous five years were used to collect health care utilization data retrospectively. Publicly available tariff books and remuneration schemes were applied to evaluate mean costs per year in Euro with 2007 as base year. Results: The annual cost of MDS patients was estimated at €14,883. Subgroup analyses showed differences in patient's characteristics and outcomes among patients treated at a hospital based versus an office based setting. Patients treated at the hospital based registry show higher cost where as the reasons for that still need to be detected. Overall per annum direct costs range from €12,543 (SD 12,967) to €24,957 (SD 36,399) in different subgroups of patients. In both groups, patients with 5q-deletion use more medication than those without deletion. Mean costs for medication in the office based setting are €5,902 for patients with isolated 5q-deletion vs. €3,932 with no deletion, respectively. Conclusion: MDS leads to a high health care utilization and resulting costs for the health care system which requires a detailed analysis of underlying services.Response to Reviewers: For reasons of a better outline, we decided to respond to your comments in a word document which is attached. Response to reviewer's comments Reviewer's comments ResponsesReviewer #1:In this retrospective study, the authors have evaluated the annual cost of MDS transfused patients in Germany. They stated that patients with 5q-deletion used significantly more resources and especially more medication than those without deletion. This paper raise two majors Criticisms : -1st. The way the data were retrospectively collected raise some issues.In fact the authors compared MDS and del5q but the collection of data were rather different in the two groups and this might also (in part) explain the difference observed in the two groups.Thank you for raising this point. We are aware of this limitation and tried to point it out in the discussion. As this was addressed as a major point by the first reviewer we decided that the respective section needed a revision, which we did in the results and discussion section.To further address this point that was also raised by the editor we conducted additional analyses of the data and present results for the center 7 (MDS registry at a university) separately in a new table 3. By this the differences in data collection and composition of the respective cohorts can be reflected. The fi...

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Section: Discussionmentioning

confidence: 99%

Cost of transfusion-dependent myelodysplastic syndrome (MDS) from a German payer’s perspective

et al. 2010

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“…Two aspects seem to be important for the quality of life of the patients: first, a higher hemoglobin level, which means probably less fatigue and a more active life; second, a decreased need for transfusions, which means fewer visits to the doctors' office and less restrictions in daily life [15,17,[49][50][51][52][53][54]. Results of health utility interviews with MDS patients show that patients associate a high hemoglobin value with achieving transfusion independence, generating new health utility values to be used in economic evaluations that compare the health outcomes of therapies in quality-adjusted life years (QALYs) [55]. In elderly compared to younger cancer patients, presence of anemia is independently associated with poor quality of life in addition to poor performance status [56].…”

Section: The Burden Of Mds: Quality Of Life and Health Economic Aspectsmentioning

confidence: 99%

Myelodysplastic Syndromes: Aspects of Current Medical Care and Economic Considerations in Germany

Gattermann

Hofmann

Meessen³

et al. 2008

Onkologie

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Myelodysplastic syndromes (MDS) are a heterogeneous group of diseases mainly affecting older people. The use of an increasing number of therapeutic options depends on a systematic risk stratification of the patients. A high percentage of MDS patients need blood transfusions as supportive care, which influence quality of life and cause a great part of the costs generated by MDS therapy. In this article which is based on a workshop about the burden of MDS held in October 2006 in Munich, MDS is discussed with regard to different aspects: current therapies, transfusion medicine, geriatrics, quality of life, and health economic aspects.

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Phm20 Value of Transfusion-Free Living in Mds: Results of Health Utility Interviews With MDS Patients

Cited by 2 publications

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Cost of transfusion-dependent myelodysplastic syndrome (MDS) from a German payer’s perspective

Cost of transfusion-dependent myelodysplastic syndrome (MDS) from a German payer’s perspective

Myelodysplastic Syndromes: Aspects of Current Medical Care and Economic Considerations in Germany

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