Haematology Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia.
Novartis Corporation (Malaysia) Sdn. Bhd, Malaysia.
Asian Pac J Cancer Prev. 2023 Mar 1;24(3):733-736. doi: 10.31557/APJCP.2023.24.3.733.
Primary myelofibrosis is a rare type of myeloproliferative neoplasm with an annual incidence rate of 0.47 per 100,000. A retrospective, observational study was conducted to determine the disease evolution and costs of treatment for myelofibrosis (MF) patients managed in 4 Ministry of Health (MOH) hospitals in Sarawak, Malaysia.
The estimation of treatment cost was a planned analysis of the Real World Evidence (RWE) study which included retrospective chart review of adult MF patients treated in Sarawak General, Sibu, Bintulu and Miri Hospitals. The study was approved by Sarawak General Hospital HRRC and MREC. The current study was conducted to estimate the cost of out-patient visits, hospitalisation, transfusion and medication from the perspective of MOH. Out-patient visits and hospitalisation costs were calculated using current unit costs for full fee-paying charges of MOH hospitals. Transfusion costs were estimated for packed cell and platelet transfusions. Medication costs were calculated using drug prices from IQVIA database for MOH hospital sub-sector in 2021. Unit costs were standardised to index year of 2021.
Data from 63 patients was available for analysis. Mean annual health resource utilisation (HRU) was 6.13 clinic visits, 9.47 days of hospitalisation and 1.61 transfusions per patient per year. Mean HRU cost was RM23,320 (USD5,217) per patient per year, comprised of RM19,122 (USD4,278) in drug costs, RM3,030 (USD678) for hospitalisation, RM799 (USD178) for transfusions and RM368 (USD82) for outpatient cost.
The present analysis suggests that medication and hospitalisation were the main drivers of costs for MF treatment in Sarawak MOH hospitals. This study provides the first RWE estimate of the cost of MF in Malaysia and may provide insight into unmet clinical needs and a guide for further health economic research into the treatment of MF.
原发性骨髓纤维化是一种罕见的骨髓增生性肿瘤，年发病率为每 10 万人 0.47 例。本回顾性观察性研究旨在确定在马来西亚砂拉越的 4 家卫生部（MOH）医院接受治疗的骨髓纤维化（MF）患者的疾病进展和治疗费用。
治疗成本的估算系真实世界证据（RWE）研究的计划性分析，其中包括对砂拉越总医院、诗巫、民都鲁和米里医院接受治疗的成年 MF 患者的回顾性病历审查。该研究获得了砂拉越总医院 HRRC 和 MREC 的批准。本研究旨在从 MOH 的角度估算门诊就诊、住院、输血和药物治疗的费用。门诊就诊和住院费用使用 MOH 医院全额付费的现行单位成本进行计算。输血费用估计为红细胞和血小板输血。药物费用根据 2021 年 IQVIA 数据库中 MOH 医院分部门的药品价格计算。单位成本已标准化为 2021 年的指数年。
可用于分析的 63 名患者的数据。每位患者的年平均卫生资源利用（HRU）为 6.13 次就诊、9.47 天住院和每年 1.61 次输血。每位患者的年平均 HRU 成本为 23,320 令吉（5,217 美元），其中药物成本为 19,122 令吉（4,278 美元），住院费用为 3,030 令吉（678 美元），输血费用为 799 令吉（178 美元），门诊费用为 368 令吉（82 美元）。
本分析表明，药物和住院治疗是沙捞越 MOH 医院 MF 治疗费用的主要驱动因素。本研究提供了马来西亚 MF 治疗成本的首个 RWE 估计值，可能为未满足的临床需求提供了一些见解，并为 MF 治疗的进一步健康经济研究提供了指导。
