Economic Burden and Healthcare Resource Use in Medicare Beneficiaries with Myelodysplastic Syndromes

OBJECTIVES: Myelodysplastic syndromes (MDS) are a heterogeneous group of disorders characterized by aberrant hematopoiesis and progressive cytopenias, diagnosed at a median age around 70 years. The objective of this study was to assess the economic and healthcare resource use (HCRU) burden of Medicare beneficiaries with MDS.

METHODS: A retrospective cross-sectional analysis of MDS patients was conducted using Medicare Part A/B claims (01/2019–09/2020). Eligible MDS patients were identified via ICD-10-CM diagnosis codes, had >12 months of continuous coverage, and were >65 years. Medicare costs for inpatient, outpatient, and physician office services were calculated on a per member per month (PMPM) basis in 2019 US dollars. Rates of all-cause inpatient admissions, red blood cell (RBC) transfusions, hematopoietic stem cell transplants (HSCT), and use of hypomethylating agents (HMA) were reported for a one-year time-interval following patients’ first observed MDS diagnosis.

RESULTS: 2,830 patients with MDS were eligible for analysis. 49.0% were female. Total PMPM cost for Part A/B claims was $2,971, with inpatient, outpatient, and physician office incurring $1,179, $925, and $867 PMPM, respectively. Within one-year following patients’ first observed claim for MDS, 41.4% of patients had >1 inpatient admission with an average length of stay of 5.9 days, and 29.8, 10.7, and 2.5% of patients received >1 RBC transfusion, HMA treatment, and/or a HSCT procedure, respectively.

CONCLUSIONS: In this single-cohort analysis of Part A/B claims, MDS patients incurred substantial healthcare expenditures to the Medicare program. Although the current analysis did not directly compare costs to the general Medicare population, in 2019 spending on traditional Medicare Part A/B beneficiaries was ~$954 PMPM. Further investigations are needed to assess the underlying drivers of costs, particularly in the setting of transfusion dependency and MDS risk category.