Exploratory Comparison of Medication Costs Among Non-Hodgkin Lymphoma Patients With and Without Z Code Documentation
Author(s)
Godwin Okoye, BPharm, MS, Anton L. Avanceña, MS, PhD;
Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
Presentation Documents
OBJECTIVES: Social and health-related factors, such as socioeconomic status and lifestyle behaviors, are associated with adverse healthcare outcomes and higher costs. Z codes in the ICD-10-CM system document these factors, offering insight into patient histories and exposures. Previous research suggests that Z codes may impact medication access thereby increasing cost. However, the impact of Z code documentation on medication costs for Non-Hodgkin Lymphoma (NHL) patients is unclear. This study compares medication costs among NHL patients with and without Z code documentation.
METHODS: We conducted a retrospective analysis using the Merative MarketScan® claims database, including patients with at least one inpatient or two outpatient NHL diagnoses between January 2016 and December 2021. Patients were categorized by Z code presence in claims, and sociodemographic characteristics were compared using descriptive statistics. Annual antineoplastic medication costs were calculated and generalized linear models (GLMs) with a log-link and gamma distribution evaluated cost differences. Statistical analysis was conducted using SAS v9.4
RESULTS: Among 129,090 NHL patients included, 4.16% had Z code documentation. These patients were more likely to be male (58.4% vs. 54.3%, p<0.001) and younger (mean age [SD]: 59.6 [15.1] vs. 60.2 [16.5] years, P<0.001). Targeted therapies were more frequently prescribed (69.8% vs 58.7%, p<0.001). Medication cost increased progressively from 2016 ($58,370 vs 63,425) to 2021 ($111,362 vs 98,440). Adjusted GLM analysis revealed significantly higher annual medication costs for patients with Z-codes [$91,959 (95% CI: 90,886-93,031)] compared to those without Z-codes [$79,250 (95% CI: 78,957-79,543)], with an average difference of ~$12,000 (p<0.001). Higher costs were driven by age, male sex, and year of medication prescription.
CONCLUSIONS: NHL patients with Z code documentation incurred higher annual medication costs, highlighting the influence of social and health-related factors on care. Addressing these disparities is essential for optimizing outcomes and reducing medication cost burdens in oncology care.
METHODS: We conducted a retrospective analysis using the Merative MarketScan® claims database, including patients with at least one inpatient or two outpatient NHL diagnoses between January 2016 and December 2021. Patients were categorized by Z code presence in claims, and sociodemographic characteristics were compared using descriptive statistics. Annual antineoplastic medication costs were calculated and generalized linear models (GLMs) with a log-link and gamma distribution evaluated cost differences. Statistical analysis was conducted using SAS v9.4
RESULTS: Among 129,090 NHL patients included, 4.16% had Z code documentation. These patients were more likely to be male (58.4% vs. 54.3%, p<0.001) and younger (mean age [SD]: 59.6 [15.1] vs. 60.2 [16.5] years, P<0.001). Targeted therapies were more frequently prescribed (69.8% vs 58.7%, p<0.001). Medication cost increased progressively from 2016 ($58,370 vs 63,425) to 2021 ($111,362 vs 98,440). Adjusted GLM analysis revealed significantly higher annual medication costs for patients with Z-codes [$91,959 (95% CI: 90,886-93,031)] compared to those without Z-codes [$79,250 (95% CI: 78,957-79,543)], with an average difference of ~$12,000 (p<0.001). Higher costs were driven by age, male sex, and year of medication prescription.
CONCLUSIONS: NHL patients with Z code documentation incurred higher annual medication costs, highlighting the influence of social and health-related factors on care. Addressing these disparities is essential for optimizing outcomes and reducing medication cost burdens in oncology care.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE37
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology