Cost of Chronic Myeloid Leukemia Care Among Patients in Advanced Phases or on Later Lines of Therapy in Chronic Phase in the United States From a Commercial and Medicare Perspective
Author(s)
Atallah EL1, Maegawa R2, Latremouille-Viau D3, Rossi C4, Guerin A3, Wu E5, Patwardhan P2
1Medical College of Wisconsin, Milwaukee, WI, USA, 2Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 3Analysis Group, Inc., Montreal, QC, Canada, 4Analysis Group, Inc., Montreal, Canada, 5Analysis Group, Inc., Boston, MA, USA
OBJECTIVES: Tyrosine kinase inhibitors (TKIs) are standard-of-care treatment for chronic myeloid leukemia-chronic phase (CML-CP). Since many patients reach later lines due to resistance/intolerance or progress to accelerated phase/blast crisis (AP/BC), a better understanding of cost of care is needed. METHODS: Adult patients with CML were identified in the IBM MarketScan (Q1/2001-Q2/2019) and SEER-Medicare (Q1/2006-Q4/2016) databases. Healthcare resource utilization (HRU: inpatient [IP] days and outpatient [OP] services) were measured among patients with (a) CML-CP on third-line therapy (CML-CP-3L), (b) CML-CP on fourth-line therapy or later (CML-CP-4L+), and (c) CML-AP/BC. Three-month incidence rates (IR) and event-level costs ($2019 USD), including 3-month terminal care and stem-cell transplant (SCT in IP settings) costs, were reported from a payer’s perspective. RESULTS: In commercial claims, 296 (4,620 patient-months), 83 (1,644 patient-months), and 949 (25,593 patient-months) patients were identified in CML-CP-3L, CML-CP-4L+, and CML-AP/BC, respectively. Three-month OP IR were 7.6, 8.3, and 7.0 services in CML-CP-3L, CML-CP-4L+, and CML-AP/BC, respectively, with mean costs of $597 per service. Three-month IP IR were 0.6, 0.7, and 1.4 days in CML-CP-3L, CML-CP-4L+, and CML-AP/BC, respectively, with mean costs of $5,892 per day. Mean costs were $107,013 for terminal care and $352,333 for SCT. In SEER-Medicare, 53 (738 patient-months), 12 (180 patient-months), and 222 patients (5,740 patient-months) were identified in CML-CP-3L, CML-CP-4L+, and CML-AP/BC, respectively. Three-month OP IR were 13.7, 20.0, and 13.8 services in CML-CP-3L, CML-CP-4L+, and CML-AP/BC, respectively, with mean costs of $230 per service. Three-month IP IR were 3.1, 1.5, and 3.6 days in CML-CP-3L, CML-CP-4L+, and CML-AP/BC, respectively, with mean costs of $2,945 per day. Mean costs were $54,793 for terminal care and $139,991 for SCT. CONCLUSIONS: Cost of CML care in the US is substantial among patients with CML who are in later lines of therapy or who progressed to AP/BC, suggesting unmet treatment needs.
Conference/Value in Health Info
2021-05, ISPOR 2021, Montreal, Canada
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Code
PCN50
Topic
Economic Evaluation
Disease
Oncology