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