OBJECTIVES : There is limited understanding of the resource utilization associated with AML pre and post midostaurin approval. The study objectives were to evaluate healthcare resource utilization between FLT3-mutated AML patients and FLT3-wildtype AML patients, pre-midostaurin approval and among FLT3-mutated AML patients post-midostaurin approval.

METHODS : Retrospective medical charts from the Huntsman Cancer Institute (HCI) identified AML patients treated with 7+3 induction chemotherapy from 2007 to July 2018. FLT3-mutated patients (FLT3m) were treated with chemotherapy and midostaurin (mido) from May 2017 to December 2018. Historical FLT3m patients and FLT3-wildtype (FLT3-wt) patients, prior to midostaurin approval, comprise FLT3m pre-mido and FLT3-wt groups, respectively. Health resource utilization including number of inpatient, outpatient, emergency visits and length of stay were determined.

RESULTS : FLT3m mido, FLT3m pre-mido and FLT3-wt groups included 7, 39 and 61 patients respectively. Overall AML-related median inpatient and outpatient visits for FLT3m mido was 9 and 50 respectively. Overall median inpatient and outpatient visits for FLT3m pre-mido and FLT3-wt were not significantly different with 5 and 6 visits (p=0.1); 47 and 51 visits (p=0.4), respectively.

Compared to FLT3-wt patients, consolidation therapy for FLT3m pre-mido patients was shorter (78 vs 33 days, p=0.0015) and consisted of fewer cycles (3 vs 2 cycles, p=0.0009) respectively. As a result, during consolidation therapy, FLT3m pre-mido patients had significantly fewer overall hospital visits (4 vs 14 visits, p=0.0006). There were no significant differences in utilization between FLT3m pre-mido and FLT3-wt groups during other treatment settings. FLT3m pre-mido patients also underwent transplant earlier than FLT3-wt patients after diagnosis (125 vs 186 days, p=0.0028).

CONCLUSIONS : FLT3m pre-mido patients had fewer consolidation cycles and underwent transplant earlier than FLT3-wt patients. Utilization was significantly lower for FLT3m-pre-mido patients compared to FLT3-wt patients during consolidation regimen despite similar overall utilization.