OBJECTIVES: This study examined annual healthcare utilization and associated healthcare costs incurred in patients diagnosed with relapse AML.

METHODS: A retrospective analysis was conducted in the Premier Healthcare Database. Using ICD-10-CM codes for AML in relapse, the study identified adult patients during the period of 1/1/2016 to 9/30/2018 and were followed from index to inpatient death, one year in relapse, or end of study period (9/30/19). Outcomes of interest included demographic data, comorbidities, outpatient treatment days, inpatient and ICU admissions, and associated costs.

RESULTS: A total of 2,290 patients were identified, mean age=61.2 and 46.9% were female. Patient follow-up varied from <90 days (49.4%), at least 180 days (32.8%), to ≥360 days (16.8%). During the one-year follow-up, outpatient hospital utilization averaged 14.6 days. For inpatient hospitalizations, mean admissions per patient were 2.4 (mean LOS=13.4 days). Among hospitalizations, 554 (30.8%) included an ICU admission (LOS=4.2). Regarding costs, mean cost per day for outpatient treatment was $1,793 for an annual cost of $17,968. The mean cost of an inpatient stay was $34,209 and mean cost of an ICU admission during a hospital stay was $23,425. Total annual inpatient treatment cost averaged $77,983. Hospital treatment the year following relapse totaled $169 million, $139 million (82%) attributable to the inpatient setting.

CONCLUSIONS: Acute myelogenous leukemia (AML), a malignant cancer of bone marrow, affects 4.3 per 100,000 individuals in the US, with a median age of 68 at diagnosis. Treatment options include intensive chemotherapy followed by post-remission therapies including stem cell transplant, less intensive chemotherapy, or supportive care. Median survival is 8-10 months. Prognosis after AML relapse is typically poor as seen in this study, and patients are commonly admitted to the hospital and ICU for treatment. This utilization comes with substantial costs, suggesting the need for therapies that may improve outcomes in AML.