Policy Analysis Inc, Brookline, MA, USA.
Amgen Inc San Francisco, South San Francisco, CA, USA.
Leuk Lymphoma. 2020 Jan;61(1):47-55. doi: 10.1080/10428194.2019.1648802. Epub 2019 Aug 7.
Effects of disease progression on healthcare resource utilization (HRU) and costs among multiple myeloma (MM) patients with ≥1 line of therapy (LOT) and without receipt of stem cell transplant were estimated using large US claims database. Disease progression was defined as advancement to the next LOT, bone metastasis, hypercalcemia, soft tissue plasmacytoma, skeletal related events, acute kidney failure, or death within 12 months of LOT initiation. Annual HRU and costs in the first four LOTs were compared for patients with versus without progression using inverse probability of treatment weighting to adjust for differences between groups in baseline characteristics. In all LOTs, mean annual hospitalizations and healthcare costs were greater for patients with versus without progression. Total incremental annual costs among patients with versus without progression in 1LOT to 4LOT were $25,920, $30,632, $47,320, and $19,769, respectively. For MM patients receiving drug therapy, the economic burden of disease progression is substantial.
使用美国大型索赔数据库估计了≥1 线治疗（LOT）且未接受干细胞移植的多发性骨髓瘤（MM）患者疾病进展对医疗资源利用（HRU）和成本的影响。疾病进展定义为在下一线治疗、骨转移、高钙血症、软组织浆细胞瘤、骨骼相关事件、急性肾衰竭或 LOT 开始后 12 个月内死亡。使用治疗反概率加权法（inverse probability of treatment weighting，IPTW）调整基线特征组间差异，比较有和无进展患者在四个一线 LOT 中的年度 HRU 和成本。在所有 LOT 中，与无进展患者相比，有进展患者的年住院和医疗费用更高。在 1LOT 到 4LOT 中，与无进展患者相比，有进展患者的总增量年成本分别为 25920 美元、30632 美元、47320 美元和 19769 美元。对于接受药物治疗的 MM 患者，疾病进展的经济负担是巨大的。
