OBJECTIVES: Assess the resource consumption and direct costs of the healthcare reimbursed by the Italian National Health Service (INHS) for patients newly diagnosed with acute myeloid leukemia (AML).

METHODS: From the Fondazione Ricerca e Salute’s database (administrative healthcare data of ~5 million inhabitants/year), newly AML diagnosed adults (in-hospital diagnosis) in 2018 (index date) and with available data since 2013, were selected. They were described by sex, age and comorbidities. Patients treated with antineoplastic therapy and undergoing allogeneic stem cell transplantation (alloSCT) were identified. Concomitant drugs, hospitalizations, outpatient specialist services and healthcare integrated direct costs charged to the INHS, were assessed within two follow-up years.

RESULTS: In 2018, patients with a new diagnosis of AML were 228 (incidence: 5.7x100,000 adults; males were 56.6%; mean age was 69±16; 84% had ≥1 comorbidity). Within one follow-up year, 171/228 subjects (75%) were treated with antineoplastic therapy, of whom 32/171 underwent alloSCT (19%). Analysable patients at the beginning of the 2nd year were 83. Among patients newly diagnosed with AML, within first and second year: 148/228 (65%) and 40/83 (48%) underwent ≥1 overnight hospitalization; 201/228 (88%) and 79/83 (95%) received ≥1 concomitant drug (antibacterials for systemic use and antacids were the most supplied); to 179/228 (78%) and 66/83 (79%) ≥1 outpatient specialist care was performed (laboratory tests were the most provided). On average, per capita, the INHS spent €45,475 and €29,452 during the first and second follow-up year, respectively; of the total costs, respectively, hospitalizations accounted for 91% (including index hospitalization) and 73% (chemotherapy sessions and alloSCT likely drove this high proportion), pharmaceuticals for 8% and 25%, and outpatient specialist care for 1% and 3%.

CONCLUSIONS: This analysis of administrative data, despite the high loss to follow-up, shows a substantial burden on the INHS in terms of healthcare resource consumption and direct costs.