Bell Jill A, Galaznik Aaron, Farrelly Eileen, Blazer Marlo, Murty Sharanya, Ogbonnaya Augustina, Eaddy Michael, Fram Robert J, Faller Douglas V, Kota Vamsi
Millennium Pharmaceuticals, Inc., 40 Landsdowne Street, Cambridge, MA, 02139, USA(1).
Xcenda, 4114 Woodlands Parkway, Suite 500, Palm Harbor, FL, 34685, USA.
Leuk Res. 2018 Aug;71:27-33. doi: 10.1016/j.leukres.2018.06.010. Epub 2018 Jun 18.
This retrospective claims database study examined healthcare utilization (HCU) and costs associated with acute myeloid leukemia (AML) in 237 elderly patients who received chemotherapy or a stem cell transplant (SCT) following AML diagnosis. Patients with secondary AML were excluded. Over the entire follow-up period, 92.0% of patients had ≥1 inpatient admission; 85.7% had ≥1 AML-related admission, and 42.6% had ≥1 non-AML-related admission. During inpatient admissions, 39.2% of patients had ≥1 intensive care unit (ICU) admission, with 20.7% having ≥1 AML-related ICU admission, and 27.8% having ≥1 non-AML-related ICU admission. Total mean per-patient per-month (PPPM) costs over the follow-up period were $25,243 (SD: $21,909), with costs from Year 1 ($27,756 [SD: $22,121]) more than double those in Year 2 ($12,953 [SD: $26,334]) following AML diagnosis. The majority of total costs were medical ($24,512 PPPM [SD: $21,704]), which included inpatient admissions ($6548 PPPM [SD: $10,777]), other outpatient visits ($5021 PPPM [SD: $7997]), supportive care ($3640 PPPM [SD: $5589], and chemotherapy administration ($2029 PPPM [SD: $2345]). Healthcare costs of treated elderly AML patients are substantial, particularly in the first year following diagnosis. Further research is needed to understand factors contributing to high costs in various settings of care for elderly AML patients.
这项回顾性索赔数据库研究调查了237例急性髓系白血病（AML）老年患者在确诊后接受化疗或干细胞移植（SCT）的医疗保健利用率（HCU）及相关费用。继发性AML患者被排除在外。在整个随访期内，92.0%的患者有≥1次住院；85.7%的患者有≥1次与AML相关的住院，42.6%的患者有≥1次与非AML相关的住院。在住院期间，39.2%的患者有≥1次重症监护病房（ICU）住院，其中20.7%的患者有≥1次与AML相关的ICU住院，27.8%的患者有≥1次与非AML相关的ICU住院。随访期内患者每月人均总成本（PPPM）为25,243美元（标准差：21,909美元），AML确诊后第1年的费用（27,756美元[标准差：22,121美元]）是第2年（12,953美元[标准差：26,334美元]）的两倍多。总成本的大部分为医疗费用（PPPM为24,512美元[标准差：21,704美元]），其中包括住院费用（PPPM为6548美元[标准差：10,777美元]）、其他门诊就诊费用（PPPM为5021美元[标准差：7997美元]）、支持性治疗费用（PPPM为3640美元[标准差：5589美元]）以及化疗给药费用（PPPM为2029美元[标准差：2345美元]）。接受治疗的老年AML患者的医疗费用很高昂，尤其是在确诊后的第一年。需要进一步研究以了解导致老年AML患者在不同护理环境中费用高昂的因素。
