CHARACTERIZING THE PATIENT JOURNEY, HEALTH CARE RESOURCE UTILIZATION, AND ECONOMIC IMPACT OF PATIENTS WITH PTLD: A U.S. CLAIMS ANALYSIS
Author(s)
Sheila Conroy, MA1, Lane Slabaugh, PharmD, MBA1, Alexa Gordon, MS2, Halley Costantino, MS2, Ashley Martin, PhD2, Kaitlyn McBride, PhD2.
1Pierre Fabre Pharmaceuticals, Secaucus, NJ, USA, 2BluePath Solutions, Los Angeles, CA, USA.
1Pierre Fabre Pharmaceuticals, Secaucus, NJ, USA, 2BluePath Solutions, Los Angeles, CA, USA.
OBJECTIVES: Post-transplant lymphoproliferative disorder (PTLD) is a rare but serious complication following solid organ (SOT) or hematopoietic cell transplantation (HCT). Despite its clinical severity, limited real-world data describe the PTLD patient journey across the continuum of care. This study assessed HCRU and costs from initial presentation of disease requiring transplant through transplant intervention and post-transplant development and treatment of PTLD.
METHODS: This retrospective observational study used the Veeva Compass all-payer claims database (January 2017-October 2025) to identify patients who developed PTLD (D47.Z1) following SOT or HCT. Patients’ HCRU were assessed longitudinally for a minimum of 12-months pre-transplant through a minimum of 12-months post-PTLD, stratified by care setting and transplant type. HCRU-associated costs were estimated using claims-specific Medicare payments; for commercial and Medicaid patients. Costs were adjusted using payer-specific ratios.
RESULTS: A total of 1,044 transplant recipients with PTLD were identified (SOT, n=884; HCT, n=160), with a mean follow-up of 40.3 months (SD ±17.5). The mean age at transplant was 55.6 years; 56% were male and 34% resided in the Southern U.S. Across the patient journey, total per-patient costs averaged $4,024,170. Costs were highest in the transplant-to-PTLD period (43%; mean follow-up 16.3, SD ±17.5 months). Standardized 12-month pre-transplant and post-PTLD periods contributed 23% and 20% of costs, respectively, despite higher pharmacy use post-PTLD. Transplant-related costs accounted for 13%. Although transplant costs were higher for SOT patients ($563,440 vs $317,049), total costs were 25% higher for HCT patients ($4,831,969 vs. $3,878,012), driven primarily by pre-transplant hospitalizations, reflecting higher HCT management intensity. Post-PTLD costs were similar for SOT and HCT, with HCRU dominated by outpatient disease management (mean of 62 visits/12 months, SD ±48).
CONCLUSIONS: Findings indicate that costs remain high throughout the PTLD patient journey, accumulating from the pre-transplant through post-PTLD periods, highlighting the need for therapies that improve patient outcomes.
METHODS: This retrospective observational study used the Veeva Compass all-payer claims database (January 2017-October 2025) to identify patients who developed PTLD (D47.Z1) following SOT or HCT. Patients’ HCRU were assessed longitudinally for a minimum of 12-months pre-transplant through a minimum of 12-months post-PTLD, stratified by care setting and transplant type. HCRU-associated costs were estimated using claims-specific Medicare payments; for commercial and Medicaid patients. Costs were adjusted using payer-specific ratios.
RESULTS: A total of 1,044 transplant recipients with PTLD were identified (SOT, n=884; HCT, n=160), with a mean follow-up of 40.3 months (SD ±17.5). The mean age at transplant was 55.6 years; 56% were male and 34% resided in the Southern U.S. Across the patient journey, total per-patient costs averaged $4,024,170. Costs were highest in the transplant-to-PTLD period (43%; mean follow-up 16.3, SD ±17.5 months). Standardized 12-month pre-transplant and post-PTLD periods contributed 23% and 20% of costs, respectively, despite higher pharmacy use post-PTLD. Transplant-related costs accounted for 13%. Although transplant costs were higher for SOT patients ($563,440 vs $317,049), total costs were 25% higher for HCT patients ($4,831,969 vs. $3,878,012), driven primarily by pre-transplant hospitalizations, reflecting higher HCT management intensity. Post-PTLD costs were similar for SOT and HCT, with HCRU dominated by outpatient disease management (mean of 62 visits/12 months, SD ±48).
CONCLUSIONS: Findings indicate that costs remain high throughout the PTLD patient journey, accumulating from the pre-transplant through post-PTLD periods, highlighting the need for therapies that improve patient outcomes.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE491
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology, SDC: Rare & Orphan Diseases