Healthcare Costs and Resource Utilization of Patients With Warm Autoimmune Hemolytic Anemia: A Nationwide Population-Based Study in Taiwan, 2017–2022
Author(s)
DaeYoung Yu, PhD1, TSE-CHIH CHOU, MS2, SHU-CHEN CHANG, PhD2, Hsiao-Wen Kao, MD3, I-Ching (Phiona) Tsai, MHA1, Ann Leon, PharmD4, Concetta Crivera, MPH, PharmD4, Alexis Krumme, ScD, MS5, Chee Jen Chang, PhD2, David Bin-Chia Wu, PhD1.
1Asia Pacific Regional Market Access, Johnson & Johnson, Singapore, Singapore, 2Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan, 3Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, 4Janssen Global Services, LLC, Johnson & Johnson, Horsham, PA, USA, 5Global Epidemiology, Johnson & Johnson, Titusville, NJ, USA.
1Asia Pacific Regional Market Access, Johnson & Johnson, Singapore, Singapore, 2Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan, 3Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, 4Janssen Global Services, LLC, Johnson & Johnson, Horsham, PA, USA, 5Global Epidemiology, Johnson & Johnson, Titusville, NJ, USA.
OBJECTIVES: Warm autoimmune hemolytic anemia (wAIHA) is a rare and heterogeneous autoimmune disorder. The patients experience cyclical natural of the condition and lack of sustained disease control. The burden of the disease is not yet well recognized. The objective of this study was to evaluate healthcare resource utilization (HCRU) and the cost of wAIHA in Taiwan.
METHODS: The National Health Insurance Research Database of Taiwan was used as a data source. The study population was defined as adult patients (aged ≥18 years) with codes of AIHA with D59.1 and with record of wAIHA-related treatments on or after the index date in 2017-2022. In HCRU analysis, patients with ≥12-month post index date were included. Gamma regression model was used to identify important factors for healthcare costs.
RESULTS: Of 1,375 newly diagnosed patients with wAIHA, 79.3% (n=1,090) of patients were hospitalized with a hospitalization rate of 128.9 per 100 person-years (PYs). 20.1% (n=276) of patients admitted to intensive care unit (ICU) with a rate of 49.5 per 100 PYs. The median ICU stay was 5 days (interquartile range [IQR]: 2.42-4.08). Average annual costs per patient (mean, median, IQR [USD]) were 8,469, 2,918, and 1,310-8,416 in all-cause healthcare cost; 1,772, 501, and 123-1,338 in wAIHA-related healthcare cost. Major cost drivers included the number of wAIHA-related ICU admission (3.18 [1.79-5.64] per admission), male sex (1.51 [1.33-1.71] vs. female), CCI score (1.27 [1.20-1.34] per score increase) in increase of all-cause healthcare cost, based on the adjusted exponentiated coefficient (95% CI).
CONCLUSIONS: This study showed significant healthcare resource utilization and financial burden of wAIHA patients. These findings highlight the need for treatment strategy that provides sustained disease control potentially reducing overall cost. Future studies should focus on advanced treatments to improve clinical outcomes and alleviate costs for both the patients and community.
METHODS: The National Health Insurance Research Database of Taiwan was used as a data source. The study population was defined as adult patients (aged ≥18 years) with codes of AIHA with D59.1 and with record of wAIHA-related treatments on or after the index date in 2017-2022. In HCRU analysis, patients with ≥12-month post index date were included. Gamma regression model was used to identify important factors for healthcare costs.
RESULTS: Of 1,375 newly diagnosed patients with wAIHA, 79.3% (n=1,090) of patients were hospitalized with a hospitalization rate of 128.9 per 100 person-years (PYs). 20.1% (n=276) of patients admitted to intensive care unit (ICU) with a rate of 49.5 per 100 PYs. The median ICU stay was 5 days (interquartile range [IQR]: 2.42-4.08). Average annual costs per patient (mean, median, IQR [USD]) were 8,469, 2,918, and 1,310-8,416 in all-cause healthcare cost; 1,772, 501, and 123-1,338 in wAIHA-related healthcare cost. Major cost drivers included the number of wAIHA-related ICU admission (3.18 [1.79-5.64] per admission), male sex (1.51 [1.33-1.71] vs. female), CCI score (1.27 [1.20-1.34] per score increase) in increase of all-cause healthcare cost, based on the adjusted exponentiated coefficient (95% CI).
CONCLUSIONS: This study showed significant healthcare resource utilization and financial burden of wAIHA patients. These findings highlight the need for treatment strategy that provides sustained disease control potentially reducing overall cost. Future studies should focus on advanced treatments to improve clinical outcomes and alleviate costs for both the patients and community.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD69
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)