COST CHANGES ASSOCIATED WITH ACHIEVING TRANSFUSION INDEPENDENCE (TI) IN PATIENTS WITH MYELODYSPLASTIC SYNDROMES (MDS)
(Abstract release date: 05/19/16)
EHA Library. Dezern A. 06/09/16; 132760; E1211
Dr. Amy Dezern
Contributions
Contributions
Abstract
Abstract: E1211
Type: Eposter Presentation
Background
Given the bone marrow failure characteristic of the disease, patients with MDS are often dependent upon red blood cell (RBC) transfusions. Guidelines from the European Society of Medical Oncology note that chronic RBC transfusions are associated with chronic anemia, leading to excess morbidity, and cannot completely resolve impaired quality of life. This transfusion dependence (TD) has been shown to be a risk factor for progression, and achieving TI is an important treatment objective.
Aims
To evaluate MDS cost patterns associated with initial periods in which patients were TD, and subsequent periods of TI.
Methods
Patients were identified from a large US claims database (2008–2013) by ICD-9 codes for MDS; the index date was the earlier of ≥ 1 inpatient or ≥ 2 outpatient claims. Patients with medical and pharmacy (Rx) coverage for ≥ 12 months pre- and ≥ 6 months post-index were included. TD was defined as ≥ 2 consecutive 8-week periods with ≥ 1 transfusion each and no interim 56-day period without transfusion; TI was defined as 8 subsequent transfusion-free weeks. Patients with high-risk MDS or acute myeloid leukemia at diagnosis were excluded. TD patients were followed until they no longer met TD criteria or end of data. Patients who subsequently became TI were followed until they returned to TD or end of data. Total costs of care were based on paid claims and reported for 24 months post-onset of TD or TI.
Results
13,741 MDS patients met the inclusion criteria regardless of transfusion needs; 2,645 (19%) were TD and 1,378 (52%) subsequently became TI. Median TD duration was 7.5 months. Age, prior treatment, baseline anemia, del(5q) mutation, and comorbidities were similar for TD patients who did and did not subsequently achieve TI. The average total cost of care (medical + Rx) was lower for TI than for TD patients ($8,138 vs $16,640 per patient-month) (Figure). TI patients had 54% lower monthly medical costs ($7,004 vs $15,289) largely due to differences in inpatient costs ($2,353 vs $7,056). Monthly Rx costs for TI patients were 16% lower than for TD patients ($1,134 vs $1,351). Over time, monthly costs for TI patients declined 50% from initial levels; TD patient costs declined 27%.
Conclusion
Patients who are TD incur significant total costs of ≥ $16,000/month. For patients who subsequently achieved TI, monthly costs were halved from TD costs and continued to decline over time. This suggests that treatment of TD patients offers the potential for a return to TI, resulting in economic benefit as well as clinical improvement.
Session topic: E-poster
Keyword(s): MDS, Transfusion
Type: Eposter Presentation
Background
Given the bone marrow failure characteristic of the disease, patients with MDS are often dependent upon red blood cell (RBC) transfusions. Guidelines from the European Society of Medical Oncology note that chronic RBC transfusions are associated with chronic anemia, leading to excess morbidity, and cannot completely resolve impaired quality of life. This transfusion dependence (TD) has been shown to be a risk factor for progression, and achieving TI is an important treatment objective.
Aims
To evaluate MDS cost patterns associated with initial periods in which patients were TD, and subsequent periods of TI.
Methods
Patients were identified from a large US claims database (2008–2013) by ICD-9 codes for MDS; the index date was the earlier of ≥ 1 inpatient or ≥ 2 outpatient claims. Patients with medical and pharmacy (Rx) coverage for ≥ 12 months pre- and ≥ 6 months post-index were included. TD was defined as ≥ 2 consecutive 8-week periods with ≥ 1 transfusion each and no interim 56-day period without transfusion; TI was defined as 8 subsequent transfusion-free weeks. Patients with high-risk MDS or acute myeloid leukemia at diagnosis were excluded. TD patients were followed until they no longer met TD criteria or end of data. Patients who subsequently became TI were followed until they returned to TD or end of data. Total costs of care were based on paid claims and reported for 24 months post-onset of TD or TI.
Results
13,741 MDS patients met the inclusion criteria regardless of transfusion needs; 2,645 (19%) were TD and 1,378 (52%) subsequently became TI. Median TD duration was 7.5 months. Age, prior treatment, baseline anemia, del(5q) mutation, and comorbidities were similar for TD patients who did and did not subsequently achieve TI. The average total cost of care (medical + Rx) was lower for TI than for TD patients ($8,138 vs $16,640 per patient-month) (Figure). TI patients had 54% lower monthly medical costs ($7,004 vs $15,289) largely due to differences in inpatient costs ($2,353 vs $7,056). Monthly Rx costs for TI patients were 16% lower than for TD patients ($1,134 vs $1,351). Over time, monthly costs for TI patients declined 50% from initial levels; TD patient costs declined 27%.
Conclusion
Patients who are TD incur significant total costs of ≥ $16,000/month. For patients who subsequently achieved TI, monthly costs were halved from TD costs and continued to decline over time. This suggests that treatment of TD patients offers the potential for a return to TI, resulting in economic benefit as well as clinical improvement.
Session topic: E-poster
Keyword(s): MDS, Transfusion
Abstract: E1211
Type: Eposter Presentation
Background
Given the bone marrow failure characteristic of the disease, patients with MDS are often dependent upon red blood cell (RBC) transfusions. Guidelines from the European Society of Medical Oncology note that chronic RBC transfusions are associated with chronic anemia, leading to excess morbidity, and cannot completely resolve impaired quality of life. This transfusion dependence (TD) has been shown to be a risk factor for progression, and achieving TI is an important treatment objective.
Aims
To evaluate MDS cost patterns associated with initial periods in which patients were TD, and subsequent periods of TI.
Methods
Patients were identified from a large US claims database (2008–2013) by ICD-9 codes for MDS; the index date was the earlier of ≥ 1 inpatient or ≥ 2 outpatient claims. Patients with medical and pharmacy (Rx) coverage for ≥ 12 months pre- and ≥ 6 months post-index were included. TD was defined as ≥ 2 consecutive 8-week periods with ≥ 1 transfusion each and no interim 56-day period without transfusion; TI was defined as 8 subsequent transfusion-free weeks. Patients with high-risk MDS or acute myeloid leukemia at diagnosis were excluded. TD patients were followed until they no longer met TD criteria or end of data. Patients who subsequently became TI were followed until they returned to TD or end of data. Total costs of care were based on paid claims and reported for 24 months post-onset of TD or TI.
Results
13,741 MDS patients met the inclusion criteria regardless of transfusion needs; 2,645 (19%) were TD and 1,378 (52%) subsequently became TI. Median TD duration was 7.5 months. Age, prior treatment, baseline anemia, del(5q) mutation, and comorbidities were similar for TD patients who did and did not subsequently achieve TI. The average total cost of care (medical + Rx) was lower for TI than for TD patients ($8,138 vs $16,640 per patient-month) (Figure). TI patients had 54% lower monthly medical costs ($7,004 vs $15,289) largely due to differences in inpatient costs ($2,353 vs $7,056). Monthly Rx costs for TI patients were 16% lower than for TD patients ($1,134 vs $1,351). Over time, monthly costs for TI patients declined 50% from initial levels; TD patient costs declined 27%.
Conclusion
Patients who are TD incur significant total costs of ≥ $16,000/month. For patients who subsequently achieved TI, monthly costs were halved from TD costs and continued to decline over time. This suggests that treatment of TD patients offers the potential for a return to TI, resulting in economic benefit as well as clinical improvement.
Session topic: E-poster
Keyword(s): MDS, Transfusion
Type: Eposter Presentation
Background
Given the bone marrow failure characteristic of the disease, patients with MDS are often dependent upon red blood cell (RBC) transfusions. Guidelines from the European Society of Medical Oncology note that chronic RBC transfusions are associated with chronic anemia, leading to excess morbidity, and cannot completely resolve impaired quality of life. This transfusion dependence (TD) has been shown to be a risk factor for progression, and achieving TI is an important treatment objective.
Aims
To evaluate MDS cost patterns associated with initial periods in which patients were TD, and subsequent periods of TI.
Methods
Patients were identified from a large US claims database (2008–2013) by ICD-9 codes for MDS; the index date was the earlier of ≥ 1 inpatient or ≥ 2 outpatient claims. Patients with medical and pharmacy (Rx) coverage for ≥ 12 months pre- and ≥ 6 months post-index were included. TD was defined as ≥ 2 consecutive 8-week periods with ≥ 1 transfusion each and no interim 56-day period without transfusion; TI was defined as 8 subsequent transfusion-free weeks. Patients with high-risk MDS or acute myeloid leukemia at diagnosis were excluded. TD patients were followed until they no longer met TD criteria or end of data. Patients who subsequently became TI were followed until they returned to TD or end of data. Total costs of care were based on paid claims and reported for 24 months post-onset of TD or TI.
Results
13,741 MDS patients met the inclusion criteria regardless of transfusion needs; 2,645 (19%) were TD and 1,378 (52%) subsequently became TI. Median TD duration was 7.5 months. Age, prior treatment, baseline anemia, del(5q) mutation, and comorbidities were similar for TD patients who did and did not subsequently achieve TI. The average total cost of care (medical + Rx) was lower for TI than for TD patients ($8,138 vs $16,640 per patient-month) (Figure). TI patients had 54% lower monthly medical costs ($7,004 vs $15,289) largely due to differences in inpatient costs ($2,353 vs $7,056). Monthly Rx costs for TI patients were 16% lower than for TD patients ($1,134 vs $1,351). Over time, monthly costs for TI patients declined 50% from initial levels; TD patient costs declined 27%.
Conclusion
Patients who are TD incur significant total costs of ≥ $16,000/month. For patients who subsequently achieved TI, monthly costs were halved from TD costs and continued to decline over time. This suggests that treatment of TD patients offers the potential for a return to TI, resulting in economic benefit as well as clinical improvement.
Session topic: E-poster
Keyword(s): MDS, Transfusion
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