Groupe d'analyse, Ltée, Montréal, QC, Canada.
Leuk Lymphoma. 2012 Jun;53(6):1146-54. doi: 10.3109/10428194.2011.643405. Epub 2012 Feb 3.
This study estimated the average lifetime costs of patients with chronic lymphocytic leukemia (CLL) relative to similar patients without cancer. An analysis of the Medicare 5% database (1999-2007) was conducted. Each patient with CLL was matched up to three patients without cancer based on year of birth, gender, race and state. Average total lifetime costs were estimated using the Kaplan-Meier sample average estimator and stratified by treatments. For patients who died, average monthly costs during continuing and terminal phases were compared between cohorts. A total of 7463 patients with CLL and 22 331 matched controls were identified (mean age: 76 years; proportion of women: 49%). The mean observation period was 39.4 months for patients with CLL and 45.9 months for matched controls. Patients with CLL incurred average costs of $87,151 compared to $47 642 for matched controls (p < 0.001). Among common CLL treatments, average costs per patient were $5140 for rituximab and $953 for radiation therapy. Compared to matched controls, patients with CLL had significantly higher monthly costs during the continuing and terminal phases. This study showed that average lifetime costs to Medicare were $87,151 for patients with CLL compared to $47,642 for matched controls without cancer, for a significant difference of $39,509.
本研究旨在估算慢性淋巴细胞白血病（CLL）患者与非癌症患者相比的平均终生成本。对 Medicare 5%数据库（1999-2007 年）进行了分析。根据患者的出生年份、性别、种族和所在州，将每位 CLL 患者与三名非癌症患者相匹配。采用 Kaplan-Meier 样本平均估计器估计平均总终生成本，并按治疗方案进行分层。对于死亡的患者，比较队列之间继续治疗和终末期的平均每月成本。共确定了 7463 例 CLL 患者和 22331 名匹配对照（平均年龄：76 岁；女性比例：49%）。CLL 患者的平均观察期为 39.4 个月，匹配对照为 45.9 个月。CLL 患者的平均费用为 87151 美元，而匹配对照为 47642 美元（p < 0.001）。在常见的 CLL 治疗中，每位患者的平均费用分别为利妥昔单抗 5140 美元和放射治疗 953 美元。与匹配对照相比，CLL 患者在继续治疗和终末期的月均费用显著更高。本研究表明，医疗保险对 CLL 患者的平均终生费用为 87151 美元，而非癌症匹配对照为 47642 美元，差异显著，为 39509 美元。
