OBJECTIVES: Estimate HRU and costs among newly diagnosed tAML/AML-MRC patients in a US commercially insured population.

METHODS: Retrospective, observational study using PharMetricsPlus® database of adults with AML (ICD-9-CM 205.0x, corresponding ICD-10-CM) diagnosed 1/2007-6/2016 (study period), and of AML patients with evidence of myelodysplastic syndrome, hematopoietic cell transplantation (HCT), radiotherapy, or cytotoxic treatment (CT) before first AML diagnosis (index date). Patients were excluded if: first AML claim was for remission/relapse; <12 months continuous enrollment pre- index; evidence of acute promyelocytic leukemia during study period. Patients with CT or HCT during post-index period were considered treated. Follow-up was partitioned into 1-6 and >6 months post-index. HRU and costs were calculated by receipt of treatment and, for treated patients, time since index date.

RESULTS: In the tAML/AML-MRC population, the mean age (years)/follow-up (months) was 58/16.7 and 65/8.8 in treated (n=2,080;72%) and untreated (n=821;28%) patients, respectively. Mean total costs were higher for treated ($352,606) versus untreated ($80,536) patients. Among treated patients, mean total costs were $179,863 and $172,743 during months 1-6 (mean 4.4 months) and months >6 (mean 12.3 months), respectively. Among treated patients, 26% had HCT; mean costs of CT during months 1-6 were $75,137 (inpatient $54,745), representing 21% of total cost for treated patients. In the overall AML population, mean age/follow-up was 55 years/18.3 months and 60 years/16.4 months in treated (n=6,415;68%) and untreated patients (n=3,040;32%), respectively; mean total costs were $173,863 and $212,214 in months 1-6 and >6, respectively, in treated patients and $79,382 in untreated patients.

CONCLUSIONS: HRU and costs of managing tAML/AML-MRC patients are considerable, accrue more rapidly during first 6 months in treated patients, and are similar to that in the overall AML population, although follow-up for tAML/AML-MRC patients is shorter, possibly reflecting poorer prognosis.