HEALTHCARE RESOURCE UTILIZATION AND COSTS IN PATIENTS WITH AML TREATED WITH POST-TRANSPLANT MAINTENANCE THERAPY
Author(s)
Rachel Kneitel, PharmD, MS1, Kyu Lee, MS, PhD2, Noemi Kreif, PhD2;
1AbbVie, North Chicago, IL, USA, 2University of Washington, Seattle, WA, USA
1AbbVie, North Chicago, IL, USA, 2University of Washington, Seattle, WA, USA
OBJECTIVES: To describe healthcare resource utilization (HCRU) and costs among commercially insured, Medicaid, and Medicare beneficiaries with AML receiving maintenance therapy after allogeneic hematopoietic cell transplantation (allo-HCT) versus allo-HCT alone.
METHODS: We conducted a retrospective cohort study using Merative MarketScan® claims data from 10/2015-3/2024. We identified AML patients who received allo-HCT and applied inverse probability treatment weighting (IPTW) to balance groups based on their baseline characteristics. All-cause monthly HCRU, defined as emergency department (ED), inpatient (IP), outpatient (OP) visits, and hospital length of stay, was assessed over a 12-month follow-up. Poisson and negative-binomial regression models estimated event rates. Healthcare costs included ED, IP, OP, and pharmacy expenditures. Transfusion burden and supportive therapy patterns were also evaluated.
RESULTS: Of 373 patients who met inclusion criteria, 43 received maintenance therapy post-allo-HCT. The maintenance group had higher HCRU across service types: office (IRR=2.46, p=0.032) and OP visits (IRR=2.57, p=0.021) were significantly increased, while IP visits rose by 30% (IRR=1.30, p=0.049). Rates for specialist clinics (IRR=2.77, p=0.096), hospitalizations (IRR=1.26, p=0.087), and ED visits (IRR=2.10, p=0.209) were higher in the maintenance group, but these differences were not statistically significant. Supportive therapy use peaked in the first three months post-allo-HCT among those receiving maintenance, however, this temporal increase was not statistically significant. Healthcare costs shifted from inpatient at transplant to pharmacy-driven by month four, with similar trends across both groups; per patient per month pharmacy costs were significantly higher in the maintenance therapy group (mean difference $3,113.54; 95% CI: $799.57-$5,427.52; p=0.009). Blood transfusion requirements were minimal and mean monthly length of stay was comparable (3.52 vs. 3.26; p=0.460).
CONCLUSIONS: Maintenance therapy following allo-HCT was associated with greater HCRU and costs, especially for outpatient and early inpatient care. These results underscore the need to balance clinical benefits of maintenance therapy with increased healthcare resource demands.
METHODS: We conducted a retrospective cohort study using Merative MarketScan® claims data from 10/2015-3/2024. We identified AML patients who received allo-HCT and applied inverse probability treatment weighting (IPTW) to balance groups based on their baseline characteristics. All-cause monthly HCRU, defined as emergency department (ED), inpatient (IP), outpatient (OP) visits, and hospital length of stay, was assessed over a 12-month follow-up. Poisson and negative-binomial regression models estimated event rates. Healthcare costs included ED, IP, OP, and pharmacy expenditures. Transfusion burden and supportive therapy patterns were also evaluated.
RESULTS: Of 373 patients who met inclusion criteria, 43 received maintenance therapy post-allo-HCT. The maintenance group had higher HCRU across service types: office (IRR=2.46, p=0.032) and OP visits (IRR=2.57, p=0.021) were significantly increased, while IP visits rose by 30% (IRR=1.30, p=0.049). Rates for specialist clinics (IRR=2.77, p=0.096), hospitalizations (IRR=1.26, p=0.087), and ED visits (IRR=2.10, p=0.209) were higher in the maintenance group, but these differences were not statistically significant. Supportive therapy use peaked in the first three months post-allo-HCT among those receiving maintenance, however, this temporal increase was not statistically significant. Healthcare costs shifted from inpatient at transplant to pharmacy-driven by month four, with similar trends across both groups; per patient per month pharmacy costs were significantly higher in the maintenance therapy group (mean difference $3,113.54; 95% CI: $799.57-$5,427.52; p=0.009). Blood transfusion requirements were minimal and mean monthly length of stay was comparable (3.52 vs. 3.26; p=0.460).
CONCLUSIONS: Maintenance therapy following allo-HCT was associated with greater HCRU and costs, especially for outpatient and early inpatient care. These results underscore the need to balance clinical benefits of maintenance therapy with increased healthcare resource demands.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO69
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Oncology, STA: Multiple/Other Specialized Treatments