Increasing Costs of Hospitalizations for Multiple Myeloma in the United States: A Database Analysis on Aggregate Costs and Patient Subpopulations
Author(s)
Frank K. Kuhr, PhD1, Mikaella N. Mishiev, Student2, William A. Spinner, Student3, Nicole Warren, MD4, Eric C. Faulkner, MPH5.
1Medical Affairs, Menarini Silicon Biosystems, Inc., Huntingdon Valley, PA, USA, 2American Heritage Research Program, Plantation, FL, USA, 3Computer Science Program, University of Central Florida, Orlando, FL, USA, 4Menarini Silicon Biosystems, Inc., Huntingdon Valley, PA, USA, 5Passage Health Associates, Durham, NC, USA.
1Medical Affairs, Menarini Silicon Biosystems, Inc., Huntingdon Valley, PA, USA, 2American Heritage Research Program, Plantation, FL, USA, 3Computer Science Program, University of Central Florida, Orlando, FL, USA, 4Menarini Silicon Biosystems, Inc., Huntingdon Valley, PA, USA, 5Passage Health Associates, Durham, NC, USA.
Presentation Documents
OBJECTIVES: Multiple myeloma (MM) is a hematologic malignancy characterized by proliferation of clonal plasma cells in the bone marrow and a set of diverse symptoms. Treatments for MM include multi-drug regimens, innovative biologics, and bone marrow transplant-related therapies. Non-Hispanic blacks (NHB) have at least 2.3-fold greater incidence per 100,000 (14.6) relative to other racial subpopulations (range 4.1-6.2; 2021 observed SEER age-adjusted). Given differences in incidence and rise in costly treatments, we sought to examine MM cost trends focusing on inpatient care across patient subpopulations.
METHODS: We analyzed National Inpatient Sample (NIS) data using the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project database (AHRQ HCUPnet) for MM inpatient cost trends and subpopulation differences.
RESULTS: Over the period from 2017 to 2021, despite no significant increase in MM discharges, national costs for MM inpatient stays significantly increased by 26% from $686 million to $864 million (p<.05) and average costs per stay increased by 22% from $32,900 to $39,900 (p<.001). This was paralleled by increases in national costs for MM inpatient stays from 2018 to 2021 for NHB patients (35%, p<.05), Hispanic patients (47%, p<.05), and patients from low-income communities (29%, p<.01). Average costs per stay increased during this period for NHB (38%, p<.001) and non-Hispanic white patients (23%, p<.001), Medicare (28%, p<.001) and privately insured patients (20%, p<.01), and across all community income levels (low, middle, and high; range 19%-28%, p<.01). Average length of stay significantly increased only for NHB patients, from 11.2 to 12.5 days (12%, p<.05).
CONCLUSIONS: The cost of MM inpatient care increased in aggregate nationally from 2017 to 2021 driven by increases in average costs per stay in specific subpopulations. Further research is needed to explore reasons for increasing costs, whether these increases result in improved clinical outcomes, and opportunities for future cost reduction.
METHODS: We analyzed National Inpatient Sample (NIS) data using the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project database (AHRQ HCUPnet) for MM inpatient cost trends and subpopulation differences.
RESULTS: Over the period from 2017 to 2021, despite no significant increase in MM discharges, national costs for MM inpatient stays significantly increased by 26% from $686 million to $864 million (p<.05) and average costs per stay increased by 22% from $32,900 to $39,900 (p<.001). This was paralleled by increases in national costs for MM inpatient stays from 2018 to 2021 for NHB patients (35%, p<.05), Hispanic patients (47%, p<.05), and patients from low-income communities (29%, p<.01). Average costs per stay increased during this period for NHB (38%, p<.001) and non-Hispanic white patients (23%, p<.001), Medicare (28%, p<.001) and privately insured patients (20%, p<.01), and across all community income levels (low, middle, and high; range 19%-28%, p<.01). Average length of stay significantly increased only for NHB patients, from 11.2 to 12.5 days (12%, p<.05).
CONCLUSIONS: The cost of MM inpatient care increased in aggregate nationally from 2017 to 2021 driven by increases in average costs per stay in specific subpopulations. Further research is needed to explore reasons for increasing costs, whether these increases result in improved clinical outcomes, and opportunities for future cost reduction.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE30
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology