Health Care Resource Utilization and Associated Costs Among Lower-Risk Myelodysplastic Syndrome Patients in France: Edelweiss Study

OBJECTIVES: Myelodysplastic syndromes (MDS) are a heterogeneous group of hematological malignancies, characterized by ineffective hematopoiesis leading to peripheral cytopenias. Implications of this pathology on resource use and associated costs are not well understood. The objective was to describe healthcare resource utilization (HCRU) and associated costs among lower-risk MDS patients in France.

METHODS: This retrospective study is based on an established, 2/100ths representative random sample of the French National Healthcare Data System, gathering claims data reimbursed in France. Adult patients with a diagnosis of MDS and receiving first-line treatment (index date) between 01/01/2018 and 31/12/2022 were included. Patients were followed until death, end of study period or loss of follow-up. Patients were split according to their red blood cell transfusion history, in line with IWG 2018 criteria, defining the Non-Transfusion Dependent (NTD) group (no transfusion within the 16 weeks prior to first-line) and the Transfusion Dependent (TD) group (transfusion within the 16 weeks prior to first-line). HCRU and costs were described according to French National Health Insurance (NHI) perspective in €2022.

RESULTS: Among the 822 patients included, 555 were NTD (67.5%) and 267 TD (32.5%). Mean age at inclusion was 80.1 years (±9.44). A greater proportion of TD patients were male. During the first year following first-line initiation (Y1), 40% of TD vs 20% of NTD patients received transfusions and the average cost of care for TD patients was 15% higher (€34,920 vs €30,096 for NTD). This cost discrepancy escalated to +72% and +61% in Y2 and Y3, respectively. TD patients incurred more hospitalizations, treatments, and transfusions, leading to elevated costs. The mean annual transfusion cost per patient increases every year of follow-up: €5,307 (Y1), €6,666 (Y2), €9,726 (Y3) and €11,899 (Y4).

CONCLUSIONS: This study highlights the economic burden of LR-MDS patients in France and underscores the increased HCRU and payer costs associated with TD.