Healthcare Resource Utilization and Time Burden in Patients With Myelodysplastic Syndromes/Neoplasms Initiating Oral Decitabine and Cedazuridine or Intravenous/Subcutaneous Hypomethylating Agents

Author(s)

Amer Zeidan, MBBS, MHS1, Ruizhi Zhao, PhD2, Lyuba Popadic, BA3, Xiyuan Wu, MSc3, Kenneth A. Taylor, DPT, PhD3.
1Yale School of Medicine, New Haven, CT, USA, 2Taiho Oncology Inc., Princeton, CT, USA, 3Komodo Health Inc., New York, NY, USA.
OBJECTIVES: Decitabine/cedazuridine (DEC-C) is the only oral hypomethylating agent (HMA) approved for myelodysplastic syndromes/neoplasms (MDS), offering an alternative to intravenous/subcutaneous (IV/SC) HMAs. This study assessed real-world healthcare resource utilization and time burden in patients with MDS receiving DEC-C or IV/SC HMAs.
METHODS: This retrospective study of US claims data from the Komodo Healthcare Map database included patients with MDS treated with DEC-C or IV/SC HMAs between Aug-01-2020 and May-31-2024 (index date: first qualifying HMA claim). Patients receiving HMAs in the 6-month (pre-index date) baseline period or with other prior cancers (except acute myeloid leukemia [AML] or chronic myelomonocytic leukemia [CMML]) were excluded. Cohorts were balanced using 1:1 propensity score matching. Outcomes included per-patient-per-month (PPPM) healthcare visits and MDS-related healthcare encounter days (a measure of time burden).
RESULTS: After matching, 292 patients were included in each of the DEC-C and IV/SC HMA cohorts (median age: 74.0 years; 71.2% vs 69.5% White; 62.7% male; 6.5% vs 5.1% with prior AML). Mean follow-up was 356 days for DEC-C and 361 days for IV/SC HMAs. Mean (SD [median]) number of all-cause healthcare visits (i.e., all visits) PPPM during follow-up were 16.6 (13.8 [13.1]) for DEC-C and 19.4 (16.0 [15.2]) for IV/SC HMAs. This included mean outpatient visits (14.1 vs 17.0), inpatient admissions (0.2 vs 0.2), and emergency room (ER) visits (0.3 vs. 0.2). Trends were similar for MDS-related visits: all visits (8.5 vs. 10.9), outpatient (7.4 vs. 9.8), inpatient (0.2 vs. 0.1), ER (0.1 vs 0.1). Mean (SD [median]) PPPM MDS-related healthcare encounter days were 8.4 (4.9 [7.8]) with DEC-C and 10.6 (5.3 [9.6]) with IV/SC HMAs.
CONCLUSIONS: Data from this large real-world database involving patients with MDS suggest that oral DEC-C is associated with fewer healthcare visits, including outpatient visits, and lower time burden (i.e., fewer MDS-related healthcare encounter days) than IV/SC HMAs.

Conference/Value in Health Info

2025-11, ISPOR Europe 2025, Glasgow, Scotland

Value in Health, Volume 28, Issue S2

Code

EE516

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

Oncology

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