Economic Burden of Hairy Cell Leukemia: A Systematic Review
Author(s)
Paridhi Gupta, BDS, MPH1, Imtiaz Samjoo, BSc, MSc, PhD2, Kerise S. Clarke, MSc2.
1EVERSANA, Pune, India, 2EVERSANA, Burlington, ON, Canada.
1EVERSANA, Pune, India, 2EVERSANA, Burlington, ON, Canada.
OBJECTIVES: Hairy cell leukemia (HCL) is a rare hematologic malignancy that necessitates prolonged treatment and continuous monitoring, leading to significant healthcare expenditures. This systematic literature review (SLR) aims to assess the economic burden of HCL by synthesizing available data on direct healthcare costs, treatment-related expenses, and the cost-effectiveness of various therapeutic approaches.
METHODS: A comprehensive literature search was conducted up to November 2024 using the OVID database to identify studies evaluating the economic impact of HCL treatment. Additionally, bibliographies of relevant systematic reviews were hand-searched to capture pertinent studies.
RESULTS: Six studies were included in the review. The findings revealed a substantial economic burden associated with HCL. The mean all-cause healthcare cost per patient was $55,904, with inpatient care representing 65% of the total costs. Chemotherapy initiation led to increased healthcare costs, with HCL-related inpatient care accounting for 81% of HCL-specific expenditures. Myelosuppression and opportunistic infections further increased costs, as inpatient expenses for affected patients were significantly higher. Cost-effectiveness analyses suggested that cladribine combined with interferon alpha was more cost-effective than standard therapy, with a considerably lower cost-effectiveness ratio for the combined therapy. In resource-limited settings, the high cost of cladribine ($2,000) presented a significant barrier to treatment access, particularly in the absence of extensive insurance coverage. Additionally, IFN-alpha-2b therapy demonstrated a 2.8-fold reduction in overall treatment costs compared to chlorambucil, resulting in savings of $9,019 per patient annually, with a cost per life-year gained of $13,800.
CONCLUSIONS: The findings underscore the significant economic burden of HCL, with inpatient care and chemotherapy being the primary cost drivers. The need for more affordable and cost-effective therapeutic alternatives is critical to alleviating the financial burden on both healthcare systems and patients.
METHODS: A comprehensive literature search was conducted up to November 2024 using the OVID database to identify studies evaluating the economic impact of HCL treatment. Additionally, bibliographies of relevant systematic reviews were hand-searched to capture pertinent studies.
RESULTS: Six studies were included in the review. The findings revealed a substantial economic burden associated with HCL. The mean all-cause healthcare cost per patient was $55,904, with inpatient care representing 65% of the total costs. Chemotherapy initiation led to increased healthcare costs, with HCL-related inpatient care accounting for 81% of HCL-specific expenditures. Myelosuppression and opportunistic infections further increased costs, as inpatient expenses for affected patients were significantly higher. Cost-effectiveness analyses suggested that cladribine combined with interferon alpha was more cost-effective than standard therapy, with a considerably lower cost-effectiveness ratio for the combined therapy. In resource-limited settings, the high cost of cladribine ($2,000) presented a significant barrier to treatment access, particularly in the absence of extensive insurance coverage. Additionally, IFN-alpha-2b therapy demonstrated a 2.8-fold reduction in overall treatment costs compared to chlorambucil, resulting in savings of $9,019 per patient annually, with a cost per life-year gained of $13,800.
CONCLUSIONS: The findings underscore the significant economic burden of HCL, with inpatient care and chemotherapy being the primary cost drivers. The need for more affordable and cost-effective therapeutic alternatives is critical to alleviating the financial burden on both healthcare systems and patients.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
SA26
Topic
Study Approaches
Topic Subcategory
Literature Review & Synthesis
Disease
SDC: Oncology, SDC: Rare & Orphan Diseases